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Liu X, Li H, Wang Y, Li S, Ren W, Yuan J, Pang Y. Discovering common pathogenetic processes between tuberculosis and COVID-19 by bioinformatics and system biology approach. Heliyon 2024; 10:e28664. [PMID: 38596062 PMCID: PMC11002586 DOI: 10.1016/j.heliyon.2024.e28664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 04/11/2024] Open
Abstract
Background SARS-CoV-2, the cause of the COVID-19 pandemic, poses a significant threat to humanity. Individuals with pulmonary tuberculosis (PTB) are at increased risk of developing severe COVID-19, due to long-term lung damage that heightens their susceptibility to full-blown disease. Methods Three COVID-19 datasets (GSE157103, GSE166253, and GSE171110) and one PTB dataset (GSE83456) were obtained from the Gene Expression Omnibus databases. Subsequently, data were subjected to weighted gene co-expression network analysis(WGCNA)followed by functional enrichment analysis using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway databases. These analyses revealed two overlapping disease-specific modules, each comprising co-regulated genes with potentially related biological functions. Using Cytoscape, we visualised the interaction network containing common disease-related genes found within the intersection between modules and predicted transcription factors (TFs). Real-time qPCR was conducted to quantify expression levels of these genes in blood samples from COVID-19 and PTB patients. Finally, DisGeNET and the Drug Signatures database were employed to analyze these common genes, unveiling their connections to clinical disease features and potential drug treatments. Results Examination of the overlap between COVID-19 and PTB gene modules unveiled 11 common genes. Functional enrichment analyses using KEGG and GO shed light on potential functional relationships among these genes, providing insights into their potential roles in the heightened mortality of PTB patients due to SARS-CoV-2 infection. Furthermore, results of various bioinformatics-based analyses of common TFs and target genes led to identification of shared pathways and therapeutic targets for PTB patients with COVID-19, along with potential drug treatments for these patients. Conclusion Our results unveiled a potential biological connection between COVID-19 and PTB, as supported by results of functional enrichment analysis that highlighted potential biological processes and signaling pathways shared by both diseases. Building on these findings, we propose potential drug treatments for PTB patients with COVID-19, pending verification of drug safety and efficacy through laboratory and multicentre studies before clinical use.
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Affiliation(s)
| | | | | | - Shanshan Li
- Department of Bacteriology and Immunology, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China
| | - Weicong Ren
- Department of Bacteriology and Immunology, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China
| | - Jinfeng Yuan
- Department of Bacteriology and Immunology, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China
| | - Yu Pang
- Department of Bacteriology and Immunology, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China
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2
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Saraswat N, Tripathy DM, Mishra A, Kumar S, Goel S. Cutaneous tuberculosis and its possible association with COVID-19. J Eur Acad Dermatol Venereol 2024; 38:e209-e211. [PMID: 37907287 DOI: 10.1111/jdv.19592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 10/27/2023] [Indexed: 11/02/2023]
Affiliation(s)
| | | | | | - Sushil Kumar
- Dermatology, Motilal Nehru Medical College, Allahabad, India
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3
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Malwe S, Bawiskar D, Wagh V. Tuberculosis and the Effectiveness of the Revised National Tuberculosis Control Program (RNTCP) to Control Tuberculosis: A Narrative Review. Cureus 2023; 15:e51418. [PMID: 38299135 PMCID: PMC10828526 DOI: 10.7759/cureus.51418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 12/30/2023] [Indexed: 02/02/2024] Open
Abstract
The revised National Tuberculosis (TB) Control Program is an initiative undertaken by the government of India and was active from 1997 to 2020. Later it was renamed as National TB Elimination Program, which eyes the complete eradication of TB by 2025. The revised National Tuberculosis Control Programme (RNTCP) is preceded by the National TB Control Program which was activated when the cases of TB were on the rise in the early 1960s and police intervention was needed. National Tobacco Control Cell (NTCP) guided the efforts until 1997 when various shortcomings, which were registered over the course of time, were addressed and the revised program was launched. It has been a mixed success as beneficiaries belonging to the reachable, urban areas were benefitted, and tribal, and backward areas were lagging behind. Although the RNTCP proved to be effective in containing TB and curing it to a certain extent, the successor of the program, which is NTEP, has set an ambitious goal of eradicating TB by 2025 which needs concerted efforts on behalf of all stakeholders.
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Affiliation(s)
- Shraddha Malwe
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Dushyant Bawiskar
- Sports Medicine, Abhinav Bindra Sports Medicine and Research Institute, Bhubaneswar, IND
| | - Vasant Wagh
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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4
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Booysen P, Wilkinson KA, Sheerin D, Waters R, Coussens AK, Wilkinson RJ. Immune interaction between SARS-CoV-2 and Mycobacterium tuberculosis. Front Immunol 2023; 14:1254206. [PMID: 37841282 PMCID: PMC10569495 DOI: 10.3389/fimmu.2023.1254206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/12/2023] [Indexed: 10/17/2023] Open
Abstract
SARS-CoV-2 and Mycobacterium tuberculosis (Mtb) are major infectious causes of death, with meta-analyses and population-based studies finding increased mortality in co-infected patients simultaneously diagnosed with COVID-19 and tuberculosis (TB). There is a need to understand the immune interaction between SARS-CoV-2 and Mtb which impacts poor outcomes for those co-infected. We performed a PubMed and preprint search using keywords [SARS-CoV-2] AND [tuberculosis] AND [Immune response], including publications after January 2020, excluding reviews or opinions. Abstracts were evaluated by authors for inclusion of data specifically investigating the innate and/or acquired immune responses to SARS-CoV-2 and Mtb in humans and animal models, immunopathological responses in co-infection and both trials and investigations of potential protection against SARS-CoV-2 by Bacille Calmette Guérin (BCG). Of the 248 articles identified, 39 were included. Incidence of co-infection is discussed, considering in areas with a high burden of TB, where reported co-infection is likely underestimated. We evaluated evidence of the clinical association between COVID-19 and TB, discuss differences and similarities in immune responses in humans and in murine studies, and the implications of co-infection. SARS-CoV-2 and Mtb have both been shown to modulate immune responses, particularly of monocytes, macrophages, neutrophils, and T cells. Co-infection may result in impaired immunity to SARS-CoV-2, with an exacerbated inflammatory response, while T cell responses to Mtb may be modulated by SARS-CoV-2. Furthermore, there has been no proven potential COVID-19 clinical benefit of BCG despite numerous large-scale clinical trials.
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Affiliation(s)
- Petro Booysen
- Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Katalin A. Wilkinson
- Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
- Department of Medicine, University of Cape Town, Cape Town, South Africa
- Tuberculosis Laboratory, The Francis Crick Institute, London, United Kingdom
| | - Dylan Sheerin
- Infectious Diseases and Immune Defence Division, The Walter & Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
- Department of Medical Biology, University of Melbourne, Parkville, VIC, Australia
| | - Robyn Waters
- Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Anna K. Coussens
- Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
- Infectious Diseases and Immune Defence Division, The Walter & Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
- Department of Medical Biology, University of Melbourne, Parkville, VIC, Australia
| | - Robert J. Wilkinson
- Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
- Department of Medicine, University of Cape Town, Cape Town, South Africa
- Tuberculosis Laboratory, The Francis Crick Institute, London, United Kingdom
- Department of Infectious Diseases, Imperial College, London, United Kingdom
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5
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Sichen L, Rui W, Yue Y, Xin L, Youbin C, Ze T, Hongfei C. Analysis of drug resistance in pulmonary tuberculosis patients with positive sputum tuberculosis culture in Northeast China. Front Pharmacol 2023; 14:1263726. [PMID: 37818197 PMCID: PMC10560708 DOI: 10.3389/fphar.2023.1263726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/15/2023] [Indexed: 10/12/2023] Open
Abstract
Objective: The objective of this study is to determine the drug resistance status of pulmonary tuberculosis patients in Jilin Province. Methods: A retrospective survey was conducted on 395 sputum culture TB-positive patients admitted to the tuberculosis hospital in Jilin Province in 2019. Sputum samples were cultured in acidic Roche medium. Drug sensitivity testing was conducted using the proportional method. Sensitivity was reported if the percentage of drug resistance was less than 1%, and resistance was reported if the percentage was ≥1%. Statistical analysis was performed using SPSS 22.0. Results: 395 tuberculosis patients with positive sputum tuberculosis culture were included in the study, with 102 being initially treated and 293 being retreated. The study population consisted of 283 males and 112 females. Sex, age, nationality, occupation, marital status, diabetes comorbidity, initial treatment, normal health status, BCG vaccine vaccination, smoking, and alcohol consumption were considered as factors that may affect the rate of multidrug resistance. And only the history of treatment (initial treatment) was associated with multidrug resistance (p = 0.032). This indicates that retreatment is the most significant risk factor for the occurrence of multidrug resistance in tuberculosis. The multidrug resistance rate in retreated patients is 3.764 times higher than that in initially treated patients. Conclusion: The prevalence of multidrug-resistant is higher in retreated patients compared to initially treated patients in the study population. Multidrug resistance is only associated with the treatment history (initial retreatment) and not with other factors.
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Affiliation(s)
- Li Sichen
- Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun, China
| | - Wang Rui
- Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun, China
- School of Public Health, Jilin University, Changchun, China
| | - Yang Yue
- Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun, China
| | - Liu Xin
- Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun, China
| | - Cui Youbin
- Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun, China
| | - Tang Ze
- Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun, China
| | - Cai Hongfei
- Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun, China
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6
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Daniel OJ, Bamidele JO, Alabi AD, Tijani MA, Akinleye CA, Oritogun KS, Soyinka FO, Adejumo OA. The effect of the Covid-19 pandemic on Tuberculosis (TB) case notification in Ogun State, Nigeria. Afr Health Sci 2023; 23:376-383. [PMID: 38357178 PMCID: PMC10862610 DOI: 10.4314/ahs.v23i3.44] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Abstract
Introduction COVID-19 pandemic has resulted in disruptions in delivery of Tuberculosis services especially, in resource-limited settings. Provisional data by the WHO from 84 countries indicates that about 1.4 million fewer people received care for tuberculosis in 2020 than in 2019. This study assessed the effect of COVID-19 pandemic on tuberculosis case notification rates in Ogun state, Nigeria. Methods A retrospective review of presumptive TB and diagnosed TB cases that were notified in 2019 and 2020. Analysis was done using Epi-info version 7.2.3.1. Level of statistical significance was p < 0.05. Results A total of 3102 and 3326 confirmed cases were reported in 2019 and 2020 respectively with an increase of 7.2%. There was significant decline in total number of cases notified in Q2, 2020 compared to 2019 (p=0.001) with a significant increase in proportion of TB cases notified by private facilities from 11.65% in 2019 to 20.27% in 2020. Conclusion Total TB cases notified in Ogun state increased during the covid-19 pandemic. There was significant decline in TB cases during the lockdown but an increase in proportion of TB cases notified by private facilities demonstrating that private facilities can withstand disruptions to TB case notifications due to the Covid-19 pandemic.
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Affiliation(s)
- Olusoji J Daniel
- Department of Community Medicine and Primary Care, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State
- Department of Community Medicine and Primary Care, Faculty of Clinical Sciences, Olabisi Onabanjo University Sagamu Campus, Ogun State
| | - Janet O Bamidele
- Department of Community Medicine and Primary Care, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State
| | - Adekunle D Alabi
- Department of Community Medicine and Primary Care, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State
- Department of Community Medicine and Primary Care, Faculty of Clinical Sciences, Olabisi Onabanjo University Sagamu Campus, Ogun State
| | - Musibau A Tijani
- State Tuberculosis, Leprosy & Buruli Ulcer Control Programme, Department of Public Health, Ministry of Health, Abeokuta, Ogun State
| | | | - Kolawole S Oritogun
- Department of Community Medicine and Primary Care, Faculty of Clinical Sciences, Olabisi Onabanjo University Sagamu Campus, Ogun State
| | - Festus O Soyinka
- State Tuberculosis, Leprosy & Buruli Ulcer Control Programme, Department of Public Health, Ministry of Health, Abeokuta, Ogun State
| | - Olusola A Adejumo
- Department of Community Health, Lagos State University Teaching Hospital Ikeja, Lagos
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7
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Aiello A, Najafi-Fard S, Goletti D. Initial immune response after exposure to Mycobacterium tuberculosis or to SARS-COV-2: similarities and differences. Front Immunol 2023; 14:1244556. [PMID: 37662901 PMCID: PMC10470049 DOI: 10.3389/fimmu.2023.1244556] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 07/31/2023] [Indexed: 09/05/2023] Open
Abstract
Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb) and Coronavirus disease-2019 (COVID-19), whose etiologic agent is severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), are currently the two deadliest infectious diseases in humans, which together have caused about more than 11 million deaths worldwide in the past 3 years. TB and COVID-19 share several aspects including the droplet- and aerosol-borne transmissibility, the lungs as primary target, some symptoms, and diagnostic tools. However, these two infectious diseases differ in other aspects as their incubation period, immune cells involved, persistence and the immunopathological response. In this review, we highlight the similarities and differences between TB and COVID-19 focusing on the innate and adaptive immune response induced after the exposure to Mtb and SARS-CoV-2 and the pathological pathways linking the two infections. Moreover, we provide a brief overview of the immune response in case of TB-COVID-19 co-infection highlighting the similarities and differences of each individual infection. A comprehensive understanding of the immune response involved in TB and COVID-19 is of utmost importance for the design of effective therapeutic strategies and vaccines for both diseases.
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Affiliation(s)
| | | | - Delia Goletti
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
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8
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Swanepoel J, van der Zalm MM, Preiser W, van Zyl G, Whittaker E, Hesseling AC, Moore DAJ, Seddon JA. SARS-CoV-2 infection and pulmonary tuberculosis in children and adolescents: a case-control study. BMC Infect Dis 2023; 23:442. [PMID: 37386354 DOI: 10.1186/s12879-023-08412-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 06/20/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND The Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) pandemic has had an impact on the global tuberculosis (TB) epidemic but evidence on the possible interaction between SARS-CoV-2 and TB, especially in children and adolescents, remains limited. We aimed to evaluate the relationship between previous infection with SARS-CoV-2 and the risk of TB in children and adolescents. METHODS An unmatched case-control study was conducted using SARS-CoV-2 unvaccinated children and adolescents recruited into two observational TB studies (Teen TB and Umoya), between November 2020 and November 2021, in Cape Town, South Africa. Sixty-four individuals with pulmonary TB (aged < 20 years) and 99 individuals without pulmonary TB (aged < 20 years) were included. Demographics and clinical data were obtained. Serum samples collected at enrolment underwent quantitative SARS-CoV-2 anti-spike immunoglobulin G (IgG) testing using the Abbott SARS-CoV-2 IgG II Quant assay. Odds ratios (ORs) for TB were estimated using unconditional logistic regression. RESULTS There was no statistically significant difference in the odds of having pulmonary TB between those who were SARS-CoV-2 IgG seropositive and those who were seronegative (adjusted OR 0.51; 95% CI: 0.23-1.11; n = 163; p = 0.09). Of those with positive SARS-CoV-2 serology indicating prior infection, baseline IgG titres were higher in individuals with TB compared to those without TB (p = 0.04) and individuals with IgG titres in the highest tertile were more likely to have pulmonary TB compared to those with IgG levels in the lowest tertile (OR: 4.00; 95%CI: 1.13- 14.21; p = 0.03). CONCLUSIONS Our study did not find convincing evidence that SARS-CoV-2 seropositivity was associated with subsequent pulmonary TB disease; however, the association between magnitude of SARS-CoV-2 IgG response and pulmonary TB warrants further investigation. Future prospective studies, evaluating the effects of sex, age and puberty on host immune responses to M. tuberculosis and SARS-CoV-2, will also provide more clarity on the interplay between these two infections.
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Affiliation(s)
- Jeremi Swanepoel
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.
- TB Centre, London School of Hygiene and Tropical Medicine, London, UK.
| | - Marieke M van der Zalm
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Wolfgang Preiser
- Division of Medical Virology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and National Health Laboratory Service, Tygerberg Academic Hospital, Cape Town, South Africa
| | - Gert van Zyl
- Division of Medical Virology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and National Health Laboratory Service, Tygerberg Academic Hospital, Cape Town, South Africa
| | | | - Anneke C Hesseling
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - David A J Moore
- TB Centre, London School of Hygiene and Tropical Medicine, London, UK
| | - James A Seddon
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- Department of Infectious Disease, Imperial College London, London, UK
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9
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Tanba C, Habib R, Chen T, Saleh N. Cavitary lung lesion as sequelae of mild COVID-19 in a patient with HIV. CLINICAL INFECTION IN PRACTICE 2023; 17:100218. [PMID: 36687139 PMCID: PMC9846880 DOI: 10.1016/j.clinpr.2023.100218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/29/2022] [Accepted: 01/13/2023] [Indexed: 01/19/2023] Open
Abstract
Cavitary lung lesions involve a large spectrum of acute to chronic infections, chronic systemic diseases, and malignancies. During the COVID-19 pandemic, we have seen an increase in lung cavitation, mainly secondary to bacterial infection however, there have been limited reports of these lesions with mild COVID-19 disease. There has been an association between severe COVID-19 infection and secondary bacterial/fungal infections and cavitary lung lesions. We report the first case of a 32-year-old man with well-controlled HIV who presented with cough and fever from what appeared to be a cavitary lesion as a sequela of his recent COVID-19 infection.
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Affiliation(s)
- Carl Tanba
- Department of Internal Medicine, Medstar Union Memorial Hospital, Baltimore, United States,Corresponding author at: 707 president street, Baltimore, MD 21202, United States
| | - Ruba Habib
- Department of Internal Medicine, Tishreen University, Latakia, Syria
| | - Terina Chen
- Department of Pathology, Medstar Union Memorial Hospital, Baltimore, United States
| | - Nahar Saleh
- Department of Internal Medicine, Medstar Union Memorial Hospital, Baltimore, United States
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10
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Xu X, Dong B, Peng L, Gao C, He Z, Wang C, Zeng J. Anti-tuberculosis drug development via targeting the cell envelope of Mycobacterium tuberculosis. Front Microbiol 2022; 13:1056608. [PMID: 36620019 PMCID: PMC9810820 DOI: 10.3389/fmicb.2022.1056608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/25/2022] [Indexed: 12/24/2022] Open
Abstract
Mycobacterium tuberculosis possesses a dynamic cell envelope, which consists of a peptidoglycan layer, a mycolic acid layer, and an arabinogalactan polysaccharide. This envelope possesses a highly complex and unique structure representing a barrier that protects and assists the growth of M. tuberculosis and allows its adaptation to the host. It regulates the immune response of the host cells, causing their damage. Therefore, the cell envelope of M. tuberculosis is an attractive target for vaccine and drug development. The emergence of multidrug-resistant as well as extensively drug resistant tuberculosis and co-infection with HIV prevented an effective control of this disease. Thus, the discovery and development of new drugs is a major keystone for TB treatment and control. This review mainly summarizes the development of drug enzymes involved in the biosynthesis of the cell wall in M. tuberculosis, and other potential drug targets in this pathway, to provide more effective strategies for the development of new drugs.
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Affiliation(s)
- Xinyue Xu
- West China-PUMC CC Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Baoyu Dong
- West China-PUMC CC Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Lijun Peng
- West China-PUMC CC Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Chao Gao
- State Key Laboratory of Biotherapy, Sichuan University, Chengdu, China.,Laboratory of Human Diseases and Immunotherapies, West China Hospital, Sichuan University, Chengdu, China
| | - Zhiqun He
- West China-PUMC CC Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Chuan Wang
- West China-PUMC CC Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jumei Zeng
- West China-PUMC CC Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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11
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Wang JY, Zong XY, Wu GH, Qi YL, Li HZ, Ji XY, Tong L, Zhang L, Yang MB, Yang PY, Li JK, Xiao FR, Zhang LS, Hu YH, Liu HD, Xu SF, Sun S, Wu W, Mao Y, Li MQ, Hou HH, Gong ZY, Guo Y, Jiao LW, Qin J, Wang DY, Wang F, Guan L, Lin G, Ma Y, Wang YP, Shi NN. 3- to 24-month Follow-up on COVID-19 with Pulmonary Tuberculosis Survivors after Discharge: Results from a Prospective, Multicenter Study. BIOMEDICAL AND ENVIRONMENTAL SCIENCES : BES 2022; 35:1091-1099. [PMID: 36597288 PMCID: PMC9850451 DOI: 10.3967/bes2022.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 10/31/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE Coronavirus disease 2019 (COVID-19) and tuberculosis (TB) are major public health and social issues worldwide. The long-term follow-up of COVID-19 with pulmonary TB (PTB) survivors after discharge is unclear. This study aimed to comprehensively describe clinical outcomes, including sequela and recurrence at 3, 12, and 24 months after discharge, among COVID-19 with PTB survivors. METHODS From January 22, 2020 to May 6, 2022, with a follow-up by August 26, 2022, a prospective, multicenter follow-up study was conducted on COVID-19 with PTB survivors after discharge in 13 hospitals from four provinces in China. Clinical outcomes, including sequela, recurrence of COVID-19, and PTB survivors, were collected via telephone and face-to-face interviews at 3, 12, and 24 months after discharge. RESULTS Thirty-two COVID-19 with PTB survivors were included. The median age was 52 (45, 59) years, and 23 (71.9%) were men. Among them, nearly two-thirds (62.5%) of the survivors were moderate, three (9.4%) were severe, and more than half (59.4%) had at least one comorbidity (PTB excluded). The proportion of COVID-19 survivors with at least one sequela symptom decreased from 40.6% at 3 months to 15.8% at 24 months, with anxiety having a higher proportion over a follow-up. Cough and amnesia recovered at the 12-month follow-up, while anxiety, fatigue, and trouble sleeping remained after 24 months. Additionally, one (3.1%) case presented two recurrences of PTB and no re-positive COVID-19 during the follow-up period. CONCLUSION The proportion of long symptoms in COVID-19 with PTB survivors decreased over time, while nearly one in six still experience persistent symptoms with a higher proportion of anxiety. The recurrence of PTB and the psychological support of COVID-19 with PTB after discharge require more attention.
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Affiliation(s)
- Jing Ya Wang
- Community Health Service Management Center, Dongcheng District, Beijing 100700, China
| | - Xing Yu Zong
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Gui Hui Wu
- Public Health Clinical Center of Chengdu, Chengdu 610066, Sichuan, China
| | - Yuan Lin Qi
- Yiyuan TCM Hospital, Zibo 256199, Shandong, China
| | - Hui Zhen Li
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Xin Yu Ji
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Lin Tong
- Institute of Information on Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Lei Zhang
- Institute of Information on Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Ming Bo Yang
- Xi'an Eighth Hospital, Xi'an 710000, Shaanxi, China
| | - Pu Ye Yang
- Xi'an Eighth Hospital, Xi'an 710000, Shaanxi, China
| | - Ji Ke Li
- Public Health Clinical Center of Chengdu, Chengdu 610066, Sichuan, China
| | - Fu Rong Xiao
- Harbin Infectious Disease Hospital, Harbin 150000, Heilongjiang, China
| | - Lin Song Zhang
- Hospital (T.C.M) Affiliated to Southwest Medical University, Luzhou 646000, Sichuan, China
| | - Yun Hong Hu
- Xingtai Hospital of Chinese Medicine, Xingtai 054000, Hebei, China
| | - Hong De Liu
- Shijiazhuang Fifth Hospital, Shijiazhuang 050000, Hebei, China
| | - Shou Fang Xu
- Jiamusi Infectious Disease Hospital, Jiamusi 154000, Heilongjiang, China
| | - Sheng Sun
- Chengde Hospital of Traditional Chinese Medicine, Chengde 067040, Hebei, China
| | - Wei Wu
- Hanzhong Central Hospital, Hanzhong 723000, Shaanxi, China
| | - Ya Mao
- Ankang Hospital of Traditional Chinese Medicine, Ankang 725000, Shaanxi, China
| | - Min Qing Li
- Department of Traditional Chinese medicine, Dazhou Central Hospital, Dazhou 635000, Sichuan, China
| | - Hao Hua Hou
- Xi'an Eighth Hospital, Xi'an 710000, Shaanxi, China
| | - Zhao Yuan Gong
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Yang Guo
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Li Wen Jiao
- China National Medicines Corporation Ltd, Beijing 100077, China
| | - Jin Qin
- Beijing University of Chinese Medicine, Beijing 101121, China
| | - Ding Yi Wang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Fang Wang
- Community Health Service Management Center, Dongcheng District, Beijing 100700, China
| | - Li Guan
- Beijing University of Chinese Medicine, Beijing 101121, China
| | - Gang Lin
- Infectious Disease Hospital of Heilongjiang Province, Harbin 150030, Heilongjiang, China
| | - Yan Ma
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Yan Ping Wang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Nan Nan Shi
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
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12
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Proposed Algorithm for Integrated Management of TB-SARS-CoV-2 Co-Infection in a TB-Endemic Country. Trop Med Infect Dis 2022; 7:tropicalmed7110367. [PMID: 36355911 PMCID: PMC9694243 DOI: 10.3390/tropicalmed7110367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/04/2022] [Accepted: 11/07/2022] [Indexed: 11/12/2022] Open
Abstract
Tuberculosis (TB) and COVID-19 have become significant health problems globally, especially in countries with high prevalence. Therefore, this research aims to examine all possibilities and predict the impact of TB-SARS-CoV-2 co-infection to anticipate the cascade effect of both diseases in all sectors. The conceptual strategy of the algorithm in TB-COVID-19 is needed to create an integrated management system. It includes the stages of early detection with accurate and effective methods, as well as the synchronization of TB-COVID-19 health services, starting from primary health facilities to secondary and tertiary referral centers. The algorithm in TB-COVID-19 is crucial to prepare future strategies for PTB co-infection viral respiratory infections other than SARS-CoV-2, ILI, ARI, and SARI. Since the implementation involves all health services, there is a need to integrate the governance of TB-COVID-19 and other comorbidities in good health services based on research and multicentre design.
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13
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Hildebrand RE, Chandrasekar SS, Riel M, Touray BJB, Aschenbroich SA, Talaat AM. Superinfection with SARS-CoV-2 Has Deleterious Effects on Mycobacterium bovis BCG Immunity and Promotes Dissemination of Mycobacterium tuberculosis. Microbiol Spectr 2022; 10:e0307522. [PMID: 36200898 PMCID: PMC9603897 DOI: 10.1128/spectrum.03075-22] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/19/2022] [Indexed: 01/04/2023] Open
Abstract
An estimated one-third of the world's population is infected with Mycobacterium tuberculosis, with the majority being vaccinated with Mycobacterium bovis BCG. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains a threat, and we must understand how SARS-CoV-2 can modulate both BCG immunity and tuberculosis pathogenesis. Interestingly, neither BCG vaccination nor tuberculosis infection resulted in differences in clinical outcomes associated with SARS-CoV-2 in transgenic mice. Surprisingly, earlier M. tuberculosis infection resulted in lower SARS-CoV-2 viral loads, mediated by the heightened immune microenvironment of the murine lungs, unlike vaccination with BCG, which had no impact. In contrast, M. tuberculosis-infected tissues had increased bacterial loads and decreased histiocytic inflammation in the lungs following SARS-CoV-2 superinfection. SARS-CoV-2 modulated BCG-induced type 17 responses while decreasing type 1 and increasing type 2 cytokines in M. tuberculosis-infected mice. These findings challenge initial findings of BCG's positive impact on SARS-CoV-2 infection and suggest potential ramifications for M. tuberculosis reactivation upon SARS-CoV-2 superinfection. IMPORTANCE Prior to SARS-CoV-2, M. tuberculosis was the leading infectious disease killer, with an estimated one-third of the world's population infected and 1.7 million deaths a year. Here, we show that SARS-CoV-2 superinfection caused increased bacterial dissemination in M. tuberculosis-infected mice along with immune and pathological changes. SARS-CoV-2 also impacted the immunity of BCG-vaccinated mice, resulting in decreased interleukin-17 (IL-17) levels, while offering no protective effect against SARS-CoV-2. These results demonstrate that SARS-CoV-2 may have a deleterious effect on the ongoing M. tuberculosis pandemic and potentially limit BCG's efficacy.
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Affiliation(s)
- Rachel E. Hildebrand
- Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin—Madison, Madison, Wisconsin, USA
| | - Shaswath Sekar Chandrasekar
- Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin—Madison, Madison, Wisconsin, USA
| | - Mariah Riel
- Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin—Madison, Madison, Wisconsin, USA
| | - Bubacarr J. B. Touray
- Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin—Madison, Madison, Wisconsin, USA
| | - Sophie A. Aschenbroich
- Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin—Madison, Madison, Wisconsin, USA
| | - Adel M. Talaat
- Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin—Madison, Madison, Wisconsin, USA
- Pan Genome Systems, Madison, Wisconsin, USA
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14
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Alessio G, Imeneo A, Di Lorenzo A, Rossi B, Sorace C, Compagno M, Coppola L, Campogiani L, Crea AMA, Malagnino V, Buccisano F, Andreoni M, Sarmati L, Iannetta M. Longitudinal Evaluation of the QuantiFERON-TB Gold Plus Assay in Hospitalized COVID-19 Patients with a First Indeterminate Result: Resolution of Inflammation and Restoration of T-Lymphocyte Counts and Interferon-Gamma Production. Microbiol Spectr 2022; 10:e0185822. [PMID: 36098523 PMCID: PMC9602342 DOI: 10.1128/spectrum.01858-22] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- Grazia Alessio
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | | | | | - Benedetta Rossi
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Chiara Sorace
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Mirko Compagno
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Luigi Coppola
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Laura Campogiani
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | | | | | - Francesco Buccisano
- Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - Massimo Andreoni
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Loredana Sarmati
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Marco Iannetta
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
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15
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Huang Y, Darr CM, Gangopadhyay K, Gangopadhyay S, Bok S, Chakraborty S. Applications of machine learning tools for ultra-sensitive detection of lipoarabinomannan with plasmonic grating biosensors in clinical samples of tuberculosis. PLoS One 2022; 17:e0275658. [PMID: 36282804 PMCID: PMC9595565 DOI: 10.1371/journal.pone.0275658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 09/21/2022] [Indexed: 11/06/2022] Open
Abstract
Background Tuberculosis is one of the top ten causes of death globally and the leading cause of death from a single infectious agent. Eradicating the Tuberculosis epidemic by 2030 is one of the top United Nations Sustainable Development Goals. Early diagnosis is essential to achieving this goal because it improves individual prognosis and reduces transmission rates of asymptomatic infected. We aim to support this goal by developing rapid and sensitive diagnostics using machine learning algorithms to minimize the need for expert intervention. Methods and findings A single molecule fluorescence immunosorbent assay was used to detect Tuberculosis biomarker lipoarabinomannan from a set of twenty clinical patient samples and a control set of spiked human urine. Tuberculosis status was separately confirmed by GeneXpert MTB/RIF and cell culture. Two machine learning algorithms, an automatic and a semiautomatic model, were developed and trained by the calibrated lipoarabinomannan titration assay data and then tested against the ground truth patient data. The semiautomatic model differed from the automatic model by an expert review step in the former, which calibrated the lower threshold to determine single molecules from background noise. The semiautomatic model was found to provide 88.89% clinical sensitivity, while the automatic model resulted in 77.78% clinical sensitivity. Conclusions The semiautomatic model outperformed the automatic model in clinical sensitivity as a result of the expert intervention applied during calibration and both models vastly outperformed manual expert counting in terms of time-to-detection and completion of analysis. Meanwhile, the clinical sensitivity of the automatic model could be improved significantly with a larger training dataset. In short, semiautomatic, and automatic Gaussian Mixture Models have a place in supporting rapid detection of Tuberculosis in resource-limited settings without sacrificing clinical sensitivity.
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Affiliation(s)
- Yilun Huang
- Department of Statistics, University of Missouri, Columbia, Missouri, United States of America
| | - Charles M. Darr
- Department of Electrical Engineering & Computer Science, Center for Nano/Micro Systems & Nanotechnology, University of Missouri, Columbia, Missouri, United States of America
| | - Keshab Gangopadhyay
- Department of Electrical Engineering & Computer Science, Center for Nano/Micro Systems & Nanotechnology, University of Missouri, Columbia, Missouri, United States of America
| | - Shubhra Gangopadhyay
- Department of Electrical Engineering & Computer Science, Center for Nano/Micro Systems & Nanotechnology, University of Missouri, Columbia, Missouri, United States of America
- * E-mail: (SG); (SB); (SC)
| | - Sangho Bok
- Department of Electrical Engineering & Computer Science, Center for Nano/Micro Systems & Nanotechnology, University of Missouri, Columbia, Missouri, United States of America
- Department of Electrical & Computer Engineering, University of Denver, Denver, Colorado, United States of America
- * E-mail: (SG); (SB); (SC)
| | - Sounak Chakraborty
- Department of Statistics, University of Missouri, Columbia, Missouri, United States of America
- * E-mail: (SG); (SB); (SC)
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16
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Canetti D, Antonello RM, Saderi L, Giro M, Goletti D, Sarmati L, Rodari P, Bocchino M, Schirò M, Riccardi N, Sotgiu G. Impact of SARS-CoV-2 infection on tuberculosis outcome and follow-up in Italy during the first COVID-19 pandemic wave: a nationwide online survey. LE INFEZIONI IN MEDICINA 2022; 30:418-426. [PMID: 36148161 PMCID: PMC9448321 DOI: 10.53854/liim-3003-10] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/27/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND SARS-CoV-2 pandemic affected tuberculosis (TB) management. This Italian nationwide survey assessed COVID-19 impact on TB care and outcomes. MATERIALS AND METHODS Twenty-one hospitals or referral centres fulfilled an online survey. Primary objective was to describe clinical features, outcomes and retention in care in subjects with latent TB infection (LTBI) or disease over the first wave of COVID-19 pandemic. Secondary objectives were the assessment of risk factors, co-morbidities, diagnostics, radiological findings, and outcomes of COVID-19 in the study population. RESULTS 254 patients with LTBI or active TB were included. In co-infected (SARS-CoV-2, LTBI/TB) patients, recovery occurred in 29/32 (90.6%) cases, death in one case. High retention in care was preserved. CONCLUSION in our cohort, outcomes did not seem to be adversely conditioned by incident COVID-19.
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Affiliation(s)
- Diana Canetti
- StopTB Italia Onlus, Milan, Italy
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Laura Saderi
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Italy
| | | | - Delia Goletti
- StopTB Italia Onlus, Milan, Italy
- National Institute for Infectious Diseases (INMI) “L. Spallanzani” - IRCCS, Rome, Italy
| | | | - Paola Rodari
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Marialuisa Bocchino
- Section of Respiratory Diseases, Department of Clinical Medicine and Surgery, Monaldi Hospital, University of Naples Federico II, Naples, Italy
| | - Miriam Schirò
- Section of Respiratory Diseases, Department of Clinical Medicine and Surgery, Monaldi Hospital, University of Naples Federico II, Naples, Italy
| | - Niccolò Riccardi
- StopTB Italia Onlus, Milan, Italy
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Italy
| | - Giovanni Sotgiu
- StopTB Italia Onlus, Milan, Italy
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Italy
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17
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Singh P, Tiwari S, Yadav A, Singh S, Thareja S, Mohimen A, Dhull P, Ahuja NB, Mitra D. Pulmonary cavitation in follow-up COVID 2019 cases: An etiological perspective. Med J Armed Forces India 2022:S0377-1237(22)00098-3. [PMID: 35999863 PMCID: PMC9388290 DOI: 10.1016/j.mjafi.2022.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 06/19/2022] [Indexed: 12/01/2022] Open
Abstract
Background The current COVID-19 pandemic is an ongoing global healthcare challenge that has caused morbidity and mortality at unprecedented levels. Since the post-COVID pulmonary complications are evolving and challenging, a study was carried out to assess pulmonary cavitation in follow-up COVID cases from an etiological perspective. The aim of this study was to assess the incidence of pulmonary cavitation and describe its etiology and evolution in moderate and severe post-COVID pneumonia patients. Methods A prospective observational study of all patients admitted to our institution with moderate or severe COVID pneumonia was carried out. Some of these patients again became symptomatic after discharge and developed pulmonary cavitation on imaging. Results 6.2% (n = 37) out of 589 patients admitted to our institution with moderate or severe COVID pneumonia developed pulmonary cavitation on follow-up. We describe the imaging characteristics of post-COVID cavitation and present these patients' clinical, laboratory, and microbiological parameters. Conclusion Cavitary lung disease in patients with moderate to severe COVID-19 disease is not uncommon, and an etiological workup is necessary to institute timely and correct therapy.
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Affiliation(s)
- Priyanka Singh
- Pulmonologist, Command Hospital (Central Command), Lucknow, India
| | - Saurabh Tiwari
- Pulmonologist, Command Hospital (Central Command), Lucknow, India
| | - Aseem Yadav
- Pulmonologist, Command Hospital (Central Command), Lucknow, India
| | | | - Sandeep Thareja
- Commandant, Command Hospital (Central Command), Lucknow, India
| | - Aneesh Mohimen
- Intervention Radiologist, Command Hospital (Central Command), Lucknow, India
| | - Pawan Dhull
- Neurologist, Command Hospital (Central Command), Lucknow, India
| | - Nitin B Ahuja
- Instructor, Officers Training College, Lucknow, India
| | - Debdeep Mitra
- Dermatologist, Command Hospital (Air Force), Bengaluru, India
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18
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COVID-19 and Pulmonary Tuberculosis Coinfection in a Moroccan Patient with Pulmonary Embolism: A Case Report and Literature Review. Case Rep Infect Dis 2022; 2022:1522876. [PMID: 35941998 PMCID: PMC9356796 DOI: 10.1155/2022/1522876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 05/22/2022] [Accepted: 06/23/2022] [Indexed: 11/23/2022] Open
Abstract
Emerging cases of coinfection of coronavirus disease 2019 (COVID-19) and tuberculosis (TB), although rare, have attracted the attention of health systems around the world and have arisen many concerns about the diagnosis, treatment, and prognosis of this coinfection especially in high TB burden countries. Here, we report a rare case and, to the best of our knowledge, the first reported case in Morocco of simultaneous diagnosis of an active pulmonary TB infection and a COVID-19 pneumonia. We present a case of a sixty-seven-year-old male patient who was admitted to our COVID-19 emergency department with a diagnosis of COVID-19 pneumonia, confirmed by nasopharyngeal swab's polymerase chain reaction (PCR) for detection of SARS-CoV-2. The atypical radiological findings suggested a TB coinfection which was later confirmed by sputum cultures and Xpert MTB/Rif assay. The patient also presented some complications including thrombosis of the left leg, pulmonary embolism and inaugural ketosis. Treatment was administered as per local protocols: broad spectrum antibiotics, corticosteroids, fixed dose-combination of antituberculosis treatment along with hydration and insulin therapy for ketosis treatment and anticoagulation. The patient was discharged after twenty-three days of hospitalization. Due to the currently limited data, further studies are necessary to establish any possible correlation between COVID-19 infection and the progression of a latent and/or the severity of an active TB infection.
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19
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Zong X, Liang N, Wang J, Li H, Wang D, Chen Y, Zhang H, Jiao L, Li A, Wu G, Li J, Wang M, Liu H, Liu Z, Zhao S, Huang J, Huang Q, Wang X, Qin J, Ma Y, Wang Y, Shi N. Treatment Effect of Qingfei Paidu Decoction Combined With Conventional Treatment on COVID-19 Patients and Other Respiratory Diseases: A Multi-Center Retrospective Case Series. Front Pharmacol 2022; 13:849598. [PMID: 35910390 PMCID: PMC9326303 DOI: 10.3389/fphar.2022.849598] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 06/14/2022] [Indexed: 11/15/2022] Open
Abstract
Background: Qingfei Paidu decoction (QFPDD) has been widely used in treating coronavirus disease 2019 (COVID-19) in China. However, studies on the treatment effect of COVID-19 patients and other respiratory diseases have not been well demonstrated. Our study aims to determine the treatment effect of QFPDD in combination with conventional treatment on COVID-19 patients and other respiratory diseases. Methods: This retrospective study recruited COVID-19 patients who were treated with QFPDD for at least two courses (6 days) from seven hospitals in five provinces from January 21 to March 18 2020. Demographic, epidemiological, clinical, laboratory, computed tomography characteristics, treatment, and outcome data were collected and analyzed. The improvements in clinical symptoms before and after QFPDD treatment were compared. Results: Eight COVID-19 patients were included in this study. Of them, six were males (75.0%). The median age of the patients was 66 (60–82) years. Four patients were classified as mild and moderate cases (50.0%); there were two severe cases (25.0%) and critical cases (25.0%). The most common symptom was cough (7 [87.5%]), followed by fever (6 [75.0%]), fatigue (4 [50.0%]), asthma (4 [50.0%]), and anorexia (3 [37.5%]). Abnormal findings included decrease in neutrophils (3 [37.5%]), lymphocytes (2 [25.0%]), alkaline phosphatase (3 [37.5%]), lactic dehydrogenase (4 [50.0%]), erythrocyte sedimentation rate (2 [25.0%]), and C-reactive protein (5 [83.3%]) at admission. After one course (3 days) of QFPDD, nasal obstruction and sore throat completely disappeared, and fever (5 [83.3%]), fatigue (2 [50.0%]), and cough (2 [28.6%]) were improved. After two courses (6 days), the fever disappeared completely in all patients, and the other symptoms showed a tendency to improve. In non-severe patients, 87.5% baseline symptoms completely disappeared. In severe patients, 61.1% of the baseline symptoms completely disappeared after patients were administered QFPDD for two courses. Of the abnormal indicators, 55.6% returned to normal levels. The median duration to complete fever recovery was 1.0 day. The median durations of viral shedding and hospitalization were 10.5 and 21.5 days, respectively. None of the patients worsened and died, and no serious adverse events occurred related to QFPDD during hospitalization. Conclusion: QFPDD combined with conventional treatment improved clinical symptoms in COVID-19 patients with other respiratory diseases, and no serious adverse reactions associated with QFPDD were observed. Larger sample studies confirm our findings in the future.
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Affiliation(s)
- Xingyu Zong
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ning Liang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jingya Wang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Huizhen Li
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Dingyi Wang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yaxin Chen
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Haili Zhang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Liwen Jiao
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - An Li
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Guihui Wu
- Public Health Clinical Center of Chengdu, Chengdu, China
| | - Jike Li
- Public Health Clinical Center of Chengdu, Chengdu, China
| | | | - Hongde Liu
- Shijiazhuang Fifth Hosipital, Shijiazhuang, China
| | - Zhang Liu
- Suihua City First Hospital, Suihua, China
| | - Shusen Zhao
- Qiqihar Institute for The Prevention and Treatment of Infectious Diseases, Qiqihar, China
| | - Jin Huang
- People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Qiuhua Huang
- People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Xiaoyan Wang
- Jinzhong Infectious Disease Hospital, Jinzhong, China
| | - Jin Qin
- Beijing University of Chinese Medicine, Beijing, China
| | - Yan Ma
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
- *Correspondence: Nannan Shi, ; Yanping Wang, ; Yan Ma,
| | - Yanping Wang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
- *Correspondence: Nannan Shi, ; Yanping Wang, ; Yan Ma,
| | - Nannan Shi
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
- *Correspondence: Nannan Shi, ; Yanping Wang, ; Yan Ma,
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20
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The challenge of tuberculosis diagnosis and management in the era of the COVID-19 pandemic and diabetes mellitus. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2022. [DOI: 10.5812/archcid-128743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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21
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Mathur SB, Saxena R, Pallavi P, Jain R, Mishra D, Jhamb U. Effect of Concomitant Tuberculosis Infection on COVID-19 Disease in Children: A Matched, Retrospective Cohort Study. J Trop Pediatr 2022; 68:6633339. [PMID: 35796754 PMCID: PMC9278261 DOI: 10.1093/tropej/fmac056] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has had devastating effects on the health of millions globally. Patients with tuberculosis (TB) are a vulnerable population. There is paucity of data to assess association between the 2 diseases in Pediatric population. OBJECTIVE To elucidate the effect of concomitant TB on clinical course of pediatric COVID-19 disease. METHODS Retrospective matched cohort study was conducted at dedicated tertiary COVID-19 hospital in India. All consecutive patients aged <18 y admitted with COVID-19 were line listed. Patients with current or recently diagnosed TB were included. Consecutive age and sex matched COVID-19 patients with no history of TB were included as controls. Medical records were retrieved, clinical data entered in pre-determined proforma. RESULTS During study period, 327 pediatric COVID-19 patients were admitted. Study group included 17 patients with TB. These patients, tended to be referred from other hospitals, be sicker, had lower SpO2 at arrival and higher severity of COVID-19 as compared to controls (All P < 0.05). They required more mechanical ventilation, had longer length of stay and worse outcome. CONCLUSION COVID-19 may secondarily affect and modify the course of TB in children. Given the high case fatality rate in this association and potentially treatable nature of TB, attention of the policy makers is drawn to this. NAME OF IEC COMMITTEE Maulana Azad Medical College and Associated Hospital Institutional Ethics Committee. IEC no: F.1/IEC/MAMC/(80/8/2020/No274). Dated 9 November 2020. TRIAL REGISTRATION CTRI/2021/02/031197 [Registered on: 10 February 2021].
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Affiliation(s)
- Surendra Bahadur Mathur
- Correspondence: Surendra Bahadur Mathur, Department of Pediatrics, Maulana Azad Medical College, Bahadur Shah Zafar Marg, New Delhi 110002, India. Tel: +919639960466. E-mail <>.
| | - Romit Saxena
- Department of Pediatrics, Maulana Azad Medical College and Associated LNJP Hospital, New Delhi, India
| | - Pallavi Pallavi
- Department of Pediatrics, Maulana Azad Medical College and Associated LNJP Hospital, New Delhi, India
| | - Rahul Jain
- Department of Pediatrics, Maulana Azad Medical College and Associated LNJP Hospital, New Delhi, India
| | - Devendra Mishra
- Department of Pediatrics, Maulana Azad Medical College and Associated LNJP Hospital, New Delhi, India
| | - Urmila Jhamb
- Department of Pediatrics, Maulana Azad Medical College and Associated LNJP Hospital, New Delhi, India
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22
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Sotgiu G, Mondoni M. TB/Covid-19: An Underestimated Risk? Arch Bronconeumol 2022; 58:742-743. [PMID: 35908987 PMCID: PMC9305372 DOI: 10.1016/j.arbres.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 07/14/2022] [Indexed: 11/13/2022]
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23
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Chen L, Liu C, Liang T, Ye Z, Huang S, Chen J, Sun X, Yi M, Zhou C, Jiang J, Chen T, Li H, Chen W, Guo H, Chen W, Yao Y, Liao S, Yu C, Wu S, Fan B, Gan Z, Zhan X. Mechanism of COVID-19-Related Proteins in Spinal Tuberculosis: Immune Dysregulation. Front Immunol 2022; 13:882651. [PMID: 35720320 PMCID: PMC9202521 DOI: 10.3389/fimmu.2022.882651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/27/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose The purpose of this article was to investigate the mechanism of immune dysregulation of COVID-19-related proteins in spinal tuberculosis (STB). Methods Clinical data were collected to construct a nomogram model. C-index, calibration curve, ROC curve, and DCA curve were used to assess the predictive ability and accuracy of the model. Additionally, 10 intervertebral disc samples were collected for protein identification. Bioinformatics was used to analyze differentially expressed proteins (DEPs), including immune cells analysis, Gene Ontology (GO) and KEGG pathway enrichment analysis, and protein-protein interaction networks (PPI). Results The nomogram predicted risk of STB ranging from 0.01 to 0.994. The C-index and AUC in the training set were 0.872 and 0.862, respectively. The results in the external validation set were consistent with the training set. Immune cells scores indicated that B cells naive in STB tissues were significantly lower than non-TB spinal tissues. Hub proteins were calculated by Degree, Closeness, and MCC methods. The main KEGG pathway included Coronavirus disease-COVID-19. There were 9 key proteins in the intersection of COVID-19-related proteins and hub proteins. There was a negative correlation between B cells naive and RPL19. COVID-19-related proteins were associated with immune genes. Conclusion Lymphocytes were predictive factors for the diagnosis of STB. Immune cells showed low expression in STB. Nine COVID-19-related proteins were involved in STB mechanisms. These nine key proteins may suppress the immune mechanism of STB by regulating the expression of immune genes.
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Affiliation(s)
- Liyi Chen
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, China
| | - Chong Liu
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, China
| | - Tuo Liang
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, China
| | - Zhen Ye
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, China
| | - Shengsheng Huang
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, China
| | - Jiarui Chen
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, China
| | - Xuhua Sun
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, China
| | - Ming Yi
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, China
| | - Chenxing Zhou
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, China
| | - Jie Jiang
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, China
| | - Tianyou Chen
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, China
| | - Hao Li
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, China
| | - Wuhua Chen
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, China
| | - Hao Guo
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, China
| | - Wenkang Chen
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, China
| | - Yuanlin Yao
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, China
| | - Shian Liao
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, China
| | - Chaojie Yu
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, China
| | - Shaofeng Wu
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, China
| | - Binguang Fan
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, China
| | - Zhaoping Gan
- Department of Hematology, Guangxi Medical University First Affiliated Hospital, Nanning, China
| | - Xinli Zhan
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, China
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24
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Parker A, Boloko L, Moolla MS, Ebrahim N, Ayele BT, Broadhurst AGB, Mashigo B, Titus G, de Wet T, Boliter N, Rosslee MJ, Papavarnavas N, Abrahams R, Mendelson M, Dlamini S, Taljaard JJ, Prozesky HW, Mowlana A, Viljoen AJ, Schrueder N, Allwood BW, Lalla U, Dave JA, Calligaro G, Levin D, Maughan D, Ntusi NAB, Nyasulu PS, Meintjes G, Koegelenberg CFN, Mnguni AT, Wasserman S. Clinical features and outcomes of COVID-19 admissions in a population with a high prevalence of HIV and tuberculosis: a multicentre cohort study. BMC Infect Dis 2022; 22:559. [PMID: 35725387 PMCID: PMC9207843 DOI: 10.1186/s12879-022-07519-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 06/01/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND There is still a paucity of evidence on the outcomes of coronavirus disease 2019 (COVID-19) among people living with human immunodeficiency virus (PWH) and those co-infected with tuberculosis (TB), particularly in areas where these conditions are common. We describe the clinical features, laboratory findings and outcome of hospitalised PWH and human immunodeficiency virus (HIV)-uninfected COVID-19 patients as well as those co-infected with tuberculosis (TB). METHODS We conducted a multicentre cohort study across three hospitals in Cape Town, South Africa. All adults requiring hospitalisation with confirmed COVID-19 pneumonia from March to July 2020 were analysed. RESULTS PWH comprised 270 (19%) of 1434 admissions. There were 47 patients with active tuberculosis (3.3%), of whom 29 (62%) were PWH. Three-hundred and seventy-three patients (26%) died. The mortality in PWH (n = 71, 26%) and HIV-uninfected patients (n = 296, 25%) was comparable. In patients with TB, PWH had a higher mortality than HIV-uninfected patients (n = 11, 38% vs n = 3, 20%; p = 0.001). In multivariable survival analysis a higher risk of death was associated with older age (Adjusted Hazard Ratio (AHR) 1.03 95%CI 1.02-1.03, p < 0.001), male sex (AHR1.38 (95%CI 1.12-1.72, p = 0.003) and being "overweight or obese" (AHR 1.30 95%CI 1.03-1.61 p = 0.024). HIV (AHR 1.28 95%CI 0.95-1.72, p 0.11) and active TB (AHR 1.50 95%CI 0.84-2.67, p = 0.17) were not independently associated with increased risk of COVID-19 death. Risk factors for inpatient mortality in PWH included CD4 cell count < 200 cells/mm3, higher admission oxygen requirements, absolute white cell counts, neutrophil/lymphocyte ratios, C-reactive protein, and creatinine levels. CONCLUSION In a population with high prevalence of HIV and TB, being overweight/obese was associated with increased risk of mortality in COVID-19 hospital admissions, emphasising the need for public health interventions in this patient population.
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Affiliation(s)
- Arifa Parker
- Division of General Medicine, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa.
| | - Linda Boloko
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Muhammad S Moolla
- Division of General Medicine, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Nabilah Ebrahim
- Department of Medicine, Khayelitsha District Hospital, Cape Town, South Africa
| | - Birhanu T Ayele
- Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Alistair G B Broadhurst
- Division of General Medicine, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Boitumelo Mashigo
- Division of General Medicine, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Gideon Titus
- Division of General Medicine, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Timothy de Wet
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Nicholas Boliter
- Department of Medicine, Khayelitsha District Hospital, Cape Town, South Africa
| | | | - Nectarios Papavarnavas
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Riezaah Abrahams
- Division of Infectious Diseases, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Marc Mendelson
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Sipho Dlamini
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Jantjie J Taljaard
- Division of Infectious Diseases, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Hans W Prozesky
- Division of Infectious Diseases, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Abdurasiet Mowlana
- Division of General Medicine, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Abraham J Viljoen
- Division of General Medicine, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Neshaad Schrueder
- Division of General Medicine, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Brian W Allwood
- Division of Pulmonology, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Usha Lalla
- Division of Pulmonology, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Joel A Dave
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Greg Calligaro
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Dion Levin
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Deborah Maughan
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Ntobeko A B Ntusi
- Department of Medicine, University of Cape Town, Cape Town, South Africa
- Extramural Unit on Intersection on Noncommunicable Diseases and Infectious Diseases, South African Medical Research Council, Cape Town, South Africa
| | - Peter S Nyasulu
- Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Graeme Meintjes
- Department of Medicine, University of Cape Town, Cape Town, South Africa
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa
- Institute for Infectious Disease and Molecular Medicine, Wellcome Centre for Infectious Diseases Research in Africa, University of Cape Town, Cape Town, South Africa
| | - Coenraad F N Koegelenberg
- Division of Pulmonology, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Ayanda T Mnguni
- Division of General Medicine, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
- Department of Medicine, Khayelitsha District Hospital, Cape Town, South Africa
| | - Sean Wasserman
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa
- Institute for Infectious Disease and Molecular Medicine, Wellcome Centre for Infectious Diseases Research in Africa, University of Cape Town, Cape Town, South Africa
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Wang Q, Guo S, Wei X, Dong Q, Xu N, Li H, Zhao J, Sun Q. Global prevalence, treatment and outcome of tuberculosis and COVID-19 coinfection: a systematic review and meta-analysis (from November 2019 to March 2021). BMJ Open 2022; 12:e059396. [PMID: 35725250 PMCID: PMC9213780 DOI: 10.1136/bmjopen-2021-059396] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION The COVID-19 outbreak poses a significant threat to the patients with tuberculosis (TB). TB and COVID-19 (TB-COVID) coinfection means the disease caused by both Mycobacterium tuberculosis and SARS-CoV-2 infection. Currently, the prevalence status, treatment and outcomes of the coinfection are poorly characterised. We aimed to systematically review the evidence on this topic and provide comprehensive information to guide the control and treatment of TB-COVID coinfection. METHODS An extensive screening was conducted using six electronic databases to search eligible studies from 1 November 2019 to 19 March 2021. Prevalence rate, treatment and outcomes of TB-COVID coinfection were extracted. Random-effects models were used to calculate mean fatality rates of coinfection with 95% CIs. The risks of bias were assessed with the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Study Reporting Prevalence Data and JBI Critical Appraisal Checklist for Case Report. A meta-analysis was conducted for subgroups on in-hospital fatality rate. RESULTS Forty-two studies were included into the analysis (35 case reports and 7 retrospective cohort studies). Nineteen countries reported coinfected patients, including high and low TB prevalence countries. The only study revealing prevalence rate came from West Cape Province, South Africa (people aged above 20 years, 0.04% until 1 June 2020 and 0.06% until 9 June 2020). The treatment regimens for coinfected patients were highly heterogeneous. The mean overall and in-hospital fatality rates of coinfection were 13.9% (95% CI: 1.6% to 26.2%) and 17.5% (95% CI: 8.9% to 26.0%). The mean in-hospital fatality rates for high-income countries (Italy and Argentina) and low/middle-income countries (LMICs) (India, Philippines, South Africa) were 6.5% (95% CI: -0.8% to ~13.9%) and 22.5% (95% CI: 19.0% to ~26.0%). CONCLUSION TB-COVID coinfection is common globally, and the coinfected patients suffer from higher fatality risk than patients with normal COVID-19. Outcomes shared significant differences between high-income countries and LMICs. PROSPERO REGISTRATION NUMBER CRD42021253660.
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Affiliation(s)
- Quan Wang
- Center for Health Management and Policy Researc, Shandong University School of Public Health, Jinan, Shandong, China
- Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - Shasha Guo
- Center for Health Management and Policy Researc, Shandong University School of Public Health, Jinan, Shandong, China
| | - Xiaolin Wei
- Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - Quanfang Dong
- Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - Ning Xu
- Department of Pulmonary and Critical Care Medicine, Weihai Municipal Hospital, Weihai, Shandong, China
- Shandong University Cheeloo College of Medicine, Jinan, Shandong, China
| | - Hui Li
- Center for Health Management and Policy Researc, Shandong University School of Public Health, Jinan, Shandong, China
| | - Jie Zhao
- Shandong University Library, Jinan, Shandong, China
| | - Qiang Sun
- Center for Health Management and Policy Researc, Shandong University School of Public Health, Jinan, Shandong, China
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26
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Mekonen KG, Obsu LL, Habtemichael TG. Optimal control analysis for the coinfection of COVID-19 and TB. ARAB JOURNAL OF BASIC AND APPLIED SCIENCES 2022. [DOI: 10.1080/25765299.2022.2085445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
| | - Legesse Lemecha Obsu
- Department of Applied Mathematics, Adama Science and Technology University, Adama, Ethiopia
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27
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Kang TG, Kwon KW, Kim K, Lee I, Kim MJ, Ha SJ, Shin SJ. Viral coinfection promotes tuberculosis immunopathogenesis by type I IFN signaling-dependent impediment of Th1 cell pulmonary influx. Nat Commun 2022; 13:3155. [PMID: 35672321 PMCID: PMC9174268 DOI: 10.1038/s41467-022-30914-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 05/06/2022] [Indexed: 01/09/2023] Open
Abstract
Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), is often exacerbated upon coinfection, but the underlying immunological mechanisms remain unclear. Here, to elucidate these mechanisms, we use an Mtb and lymphocytic choriomeningitis virus coinfection model. Viral coinfection significantly suppresses Mtb-specific IFN-γ production, with elevated bacterial loads and hyperinflammation in the lungs. Type I IFN signaling blockade rescues the Mtb-specific IFN-γ response and ameliorates lung immunopathology. Single-cell sequencing, tissue immunofluorescence staining, and adoptive transfer experiments indicate that viral infection-induced type I IFN signaling could inhibit CXCL9/10 production in myeloid cells, ultimately impairing pulmonary migration of Mtb-specific CD4+ T cells. Thus, our study suggests that augmented and sustained type I IFNs by virus coinfection prior to the pulmonary localization of Mtb-specific Th1 cells exacerbates TB immunopathogenesis by impeding the Mtb-specific Th1 cell influx. Our study highlights a negative function of viral coinfection-induced type I IFN responses in delaying Mtb-specific Th1 responses in the lung. Viral coinfection alongside mycobacterium tuberculosis (Mtb) infection may lead to immune complications or interference with immune responses. Here the authors show that in mice infected with Mtb and LCMV virus the specific TH1 response to MTb is reduced through a type I IFN response to the infecting virus.
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Affiliation(s)
- Tae Gun Kang
- Department of Biochemistry, College of Life Science & Biotechnology, Yonsei University, Seoul, 03722, Republic of Korea.,Brain Korea 21 (BK21) FOUR Program, Yonsei Education & Research Center for Biosystems, Yonsei University, Seoul, 03722, Republic of Korea
| | - Kee Woong Kwon
- Department of Microbiology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Kyungsoo Kim
- Department of Biochemistry, College of Life Science & Biotechnology, Yonsei University, Seoul, 03722, Republic of Korea.,Institute for Breast Cancer Precision Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Insuk Lee
- Department of Biotechnology, College of Life Science & Biotechnology, Yonsei University, Seoul, 03722, Republic of Korea
| | - Myeong Joon Kim
- Department of Biochemistry, College of Life Science & Biotechnology, Yonsei University, Seoul, 03722, Republic of Korea.,Brain Korea 21 (BK21) FOUR Program, Yonsei Education & Research Center for Biosystems, Yonsei University, Seoul, 03722, Republic of Korea
| | - Sang-Jun Ha
- Department of Biochemistry, College of Life Science & Biotechnology, Yonsei University, Seoul, 03722, Republic of Korea. .,Brain Korea 21 (BK21) FOUR Program, Yonsei Education & Research Center for Biosystems, Yonsei University, Seoul, 03722, Republic of Korea.
| | - Sung Jae Shin
- Department of Microbiology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea. .,Institute for Immunology and Immunological Disease, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea.
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28
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Bhayana S, Kalra M, Sachdeva P, Sachdev A, Sachdeva A. Unique Challenges Faced by a Child with Standard Risk Leukemia in Post-COVID Era: A Case Report. Indian J Crit Care Med 2022; 26:733-735. [PMID: 35836624 PMCID: PMC9237153 DOI: 10.5005/jp-journals-10071-24236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Children with malignancies are facing new challenges in post-COVID-19 era. We report an interesting case of a child on treatment for acute lymphoblastic leukemia having a very protracted course of illness with complications not often seen with standard therapy. It intends to make pediatric oncologists and intensive care specialists wary of potential newer complications.
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Affiliation(s)
- Swati Bhayana
- Department of Pediatric Hematology Oncology and BMT Unit, Sir Ganga Ram Hospital, New Delhi, India
| | - Manas Kalra
- Department of Pediatric Hematology Oncology and BMT Unit, Sir Ganga Ram Hospital, New Delhi, India
| | - Pallavi Sachdeva
- Department of Pediatric Hematology Oncology, Sir Ganga Ram Hospital, New Delhi, India
| | - Anil Sachdev
- Division of Pediatric Critical Care, Department of Pediatrics, Sir Ganga Ram Hospital, New Delhi, India
| | - Anupam Sachdeva
- Department of Pediatric Hematology Oncology, Sir Ganga Ram Hospital, New Delhi, India
- Anupam Sachdeva, Department of Pediatric Hematology Oncology, Sir Ganga Ram Hospital, New Delhi, India, Phone: +91 9811043476, e-mail:
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29
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Yang DL, Li W, Pan MH, Su HX, Li YN, Tang MY, Song XK. Spatial analysis and influencing factors of pulmonary tuberculosis among students in Nanning, during 2012–2018. PLoS One 2022; 17:e0268472. [PMID: 35609085 PMCID: PMC9129035 DOI: 10.1371/journal.pone.0268472] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 04/30/2022] [Indexed: 11/19/2022] Open
Abstract
Background
Economically underdeveloped areas in western China are hotspots of tuberculosis, especially among students. However, the related spatial and temporal patterns and influencing factors are still unclear and there are few studies to analyze the causes of pulmonary tuberculosis in students from the perspective of space.
Methods
We collected data regarding the reported incidence of pulmonary tuberculosis (PTB) among students at township level in Nanning, from 2012 to 2018. The reported incidence of pulmonary tuberculosis among students in Nanning was analyzed using spatial autocorrelation and spatial scan statistical analysis to depict hotspots of PTB incidence and spatial and temporal clustering. Spatial panel data of the reported incidence rates and influencing factors at district and county levels in Nanning were collected from 2015 to 2018. Then, we analyzed the spatial effects of incidence and influencing factors using the spatial Durbin model to explore the mechanism of each influencing factor in areas with high disease prevalence under spatial effects.
Results
From 2012 to 2018, 1609 cases of PTB were reported among students in Nanning, with an average annual reported incidence rate of 14.84/100,000. Through the Joinpoint regression model, We observed a steady trend in the percentage of cases reported each year (P>0.05). There was spatial autocorrelation between the annual reported incidence and the seven-years average reported incidence from 2012 to 2018. The high-incidence area was distributed in the junction of six urban areas and spread to the periphery, with the junction at the center. The population of college students, per capita financial expenditure on health, per capita gross domestic product, and the number of health technicians per 1,000 population were all influencing factors in the reported incidence of PTB among students.
Conclusion
We identified spatial clustering of the reported incidence of PTB among students in Nanning, mainly located in the urban center and its surrounding areas. The clustering gradually decreased from the urban center to the surrounding areas. Spatial effects influenced the reported incidence of PTB. The population density of college students, per capita health financial expenditure, gross domestic product (GDP) per capita, and the number of health technicians per 1,000 were all influencing factors in the reported incidence of PTB among students.
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Affiliation(s)
- Dan-ling Yang
- Department of Health Statistics, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Wen Li
- Department of Health Statistics, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Meng-hua Pan
- School of Information and Management, Guangxi Medical University, Nanning, Guangxi, China
| | - Hai-xia Su
- Department of Health Statistics, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Yan-ning Li
- Department of Health Statistics, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- * E-mail:
| | - Meng-ying Tang
- Department of Health Statistics, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Xiao-kun Song
- Department of Health Statistics, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
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30
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Mandal A, Verma AK, Kar SK, Bajpai J, Kant S, Kumar S, Kushwaha RAS, Garg R, Srivastava A, Bajaj DK, Verma SK, Chaudhary SC. A cross-sectional study to determine the psychological distress among pulmonary tuberculosis patients during COVID-19 pandemic. Monaldi Arch Chest Dis 2022; 93. [PMID: 35593023 DOI: 10.4081/monaldi.2022.2255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/06/2022] [Indexed: 01/24/2023] Open
Abstract
COVID-19 pandemic had adversely affected the services of the National Tuberculosis (TB) Elimination Programme, resulting in psychological distress among pulmonary tuberculosis patients (PTB). This cross-sectional, hospital-based study included 361 PTB patients. Three pre-defined questionnaires were used for the analysis, a questionnaire to evaluate anxiety related to COVID-19, a patient health questionnaire (PHQ-9) for depression, and a fear of COVID-19 scale (FCV-19S) questionnaire. Among 361 PTB patients, 13% (n=47) had COVID-19 infection. Out of the total patients, 69% (n=250) were DR-TB (drug resistance-tuberculosis) cases. Proportion of anxiety, fear and depression due to COVID-19 was found in 49% (n=177), 23% (n=83), 67% (n=247) respectively. Delay in the initiation of anti-tubercular treatment was found in 58% (n=210) of the cases, among which the majority, i.e., 69% (n=172, p=0.011), were DR-TB. This pandemic has led to a sudden step-down of PTB. Trend analysis of the psychological distress showed a peak following the COVID-19 pandemic. Most DR-TB patients had delayed initiation of the anti-tubercular treatment during the pandemic. The preponderance of the younger age group was seen in the pulmonary tuberculosis patients, and a majority of them had DR-TB. Depression was the predominant psychological distress among the study subjects during the pandemic.
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Affiliation(s)
- Ankita Mandal
- Department of Respiratory Medicine, King George's Medical University, Lucknow.
| | - Ajay Kumar Verma
- Department of Respiratory Medicine, King George's Medical University, Lucknow.
| | - Sujit Kumar Kar
- Department of Psychiatry, King George's Medical University, Lucknow.
| | - Jyoti Bajpai
- Department of Respiratory Medicine, King George's Medical University, Lucknow.
| | - Surya Kant
- Department of Respiratory Medicine, King George's Medical University, Lucknow.
| | - Santosh Kumar
- Department of Respiratory Medicine, King George's Medical University, Lucknow.
| | | | - Rajiv Garg
- Department of Respiratory Medicine, King George's Medical University, Lucknow.
| | - Anand Srivastava
- Department of Respiratory Medicine, King George's Medical University, Lucknow.
| | - Darshan Kumar Bajaj
- Department of Respiratory Medicine, King George's Medical University, Lucknow.
| | - Sanjeev Kumar Verma
- Department of Respiratory Medicine, King George's Medical University, Lucknow.
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31
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Second infection with SARS-CoV-2 wild-type is associated with increased disease burden after primary SARS-CoV-2/HBoV-1 coinfection, Cologne, Germany. Access Microbiol 2022. [DOI: 10.1099/acmi.0.000339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
SARS-CoV-2 is the cause of the still-ongoing COVID-19 pandemic. To date reports on re-infections after full recovery from a previous COVID-19 course remain limited due to the fact that re-infections or second infections occur at the earliest between 3 to 24 months after full recovery while the pandemic lasts only since a year. Even less data are available on re-infections associated with emerging variants.
A 33-year-old previously healthy male patient was tested twice SARS-CoV-2 RNA positive with an 8 months symptom-free interval between the two COVID-19 episodes in our setting in Cologne, Germany. While the first episode was accompanied by a co-detection of human bocavirus and hardly any symptoms, the second episode was characterized by serious illness and severe flu-like symptoms, although hospitalization was not required. After the first episode no residual viral RNA was detected after the patient was released from quarantine. Follow up of the patient revealed a moderate but significant reduction of the lung volume and slightly impaired diffusion capacity.
Conclusion. While it is known that re-infections with SARS-CoV-2 may occur this is the first report of a co-detection of human bocavirus (HBoV) during a primary SARS-CoV-2 infection. The first, hardly symptomatic episode showed that co-infections do not necessarily initiate severe COVID-19 courses. The second more severe episode with serious flu-like symptoms could be explained by the sustained mild damage of the airways during the primary infection.
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Cardoso-Landivar J, Jiménez-Fuentes MA, de Souza-Galvão ML. Reactivación de tuberculosis después de un caso de neumonía por SARS-CoV-2. Arch Bronconeumol 2022; 58:764-765. [PMID: 35550308 PMCID: PMC9045861 DOI: 10.1016/j.arbres.2022.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 11/29/2022]
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Yamaguchi Y, Hashimoto M, Saito S, Morita T, Tsukada A, Kusaba Y, Katsuno T, Suzuki M, Takasaki J, Izumi S, Matsunaga A, Ishizaka Y, Hojo M, Sugiyama H. Suspected Tuberculous Pleurisy and Coronavirus Disease 2019 Comorbidity. Intern Med 2022; 61:913-916. [PMID: 34980790 PMCID: PMC8987240 DOI: 10.2169/internalmedicine.6920-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
A 33-year-old woman with a fever, cough, and pharyngitis was admitted after left-sided pleural effusion was detected. The fever and upper respiratory symptoms were confirmed, and she was diagnosed with coronavirus disease (COVID-19) after showing a positive polymerase chain reaction (PCR) test. After thoracentesis, pleural fluid revealed elevated adenosine deaminase values and a positive QuantiFeron test; tuberculous pleurisy was thus suspected. Subsequent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR and anti-SARS-CoV-2 Spike IgG tests were negative, suggesting that the initial PCR result had been erroneous. However, we were unable to confirm this. Data concerning COVID-19 diagnostics are insufficient at present. It is important to make comprehensive judgments regarding the diagnosis and treatment of patients as well as public health.
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Affiliation(s)
- Yoh Yamaguchi
- Department of Respiratory Medicine, Hospital, National Center for Global Health and Medicine, Japan
| | - Masao Hashimoto
- Department of Respiratory Medicine, Hospital, National Center for Global Health and Medicine, Japan
| | - Susumu Saito
- Department of Respiratory Medicine, Hospital, National Center for Global Health and Medicine, Japan
| | - Tie Morita
- Department of Respiratory Medicine, Hospital, National Center for Global Health and Medicine, Japan
| | - Akinari Tsukada
- Department of Respiratory Medicine, Hospital, National Center for Global Health and Medicine, Japan
| | - Yusaku Kusaba
- Department of Respiratory Medicine, Hospital, National Center for Global Health and Medicine, Japan
| | - Takashi Katsuno
- Department of Respiratory Medicine, Hospital, National Center for Global Health and Medicine, Japan
| | - Manabu Suzuki
- Department of Respiratory Medicine, Hospital, National Center for Global Health and Medicine, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, Hospital, National Center for Global Health and Medicine, Japan
| | - Shinyu Izumi
- Department of Respiratory Medicine, Hospital, National Center for Global Health and Medicine, Japan
| | - Akihiro Matsunaga
- Department of Intractable Diseases, Research Institute, National Center for Global Health and Medicine, Japan
| | - Yukihito Ishizaka
- Department of Intractable Diseases, Research Institute, National Center for Global Health and Medicine, Japan
| | - Masayuki Hojo
- Department of Respiratory Medicine, Hospital, National Center for Global Health and Medicine, Japan
| | - Haruhito Sugiyama
- Department of Respiratory Medicine, Hospital, National Center for Global Health and Medicine, Japan
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Torres PPTES, Rabahi MF. Tuberculose em tempos de COVID-19: não podemos perder o foco no diagnóstico. Radiol Bras 2022; 55:V-VI. [PMID: 35414735 PMCID: PMC8993171 DOI: 10.1590/0100-3984.2022.55.2e1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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35
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Morel Z, Suarez R, Avalos E, Velázquez S, Martínez F, Lezcano V, Astigarraga N, Ghezzi C, Brizuela S, Samudio G. Multisystemic inflammatory syndrome related to COVID-19, with latent tuberculosis in bone marrow, and satisfactory response to tocilizumab, in a 7-year-old boy. Reumatismo 2022; 73. [DOI: 10.4081/reumatismo.2021.1448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 11/11/2021] [Indexed: 11/23/2022] Open
Abstract
Paediatric inflammatory multisystem syndrome temporally associated with COVID-19 (PIMS-TS) or multisystem inflammatory syndrome in children (MIS-C) is a new acute-onset systemic inflammatory disease, which mainly affects children. Latent tuberculosis infection (LTBI) is characterized by the presence of immune sensitization to Mycobacterium tuberculosis (MTB) in the absence of any clinical or radiological evidence of active disease. We present a child with MIS-C related to COVID-19, with latent TB in the bone marrow, and satisfactory response to tocilizumab. It is important to pay attention in the investigation of TB cases in countries with a high prevalence of tuberculosis, especially when opting for immunusuppression.
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Shirani K, Sherafat A, Ashraf M, Vosough K, Cruickshank T. TB and HIV surveillance amid COVID-19 pandemic. Indian J Sex Transm Dis AIDS 2022; 43:85-86. [PMID: 35846527 PMCID: PMC9282699 DOI: 10.4103/ijstd.ijstd_98_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 03/19/2021] [Indexed: 12/03/2022] Open
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The Cavity as a Lasting Abode for Tuberculous Bacilli: An Observational Study. SN COMPREHENSIVE CLINICAL MEDICINE 2022; 4:40. [PMID: 35071986 PMCID: PMC8762190 DOI: 10.1007/s42399-021-01098-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 12/10/2021] [Indexed: 12/30/2022]
Abstract
The aim of this study was to determine the factors associated with persistent sputum positivity at the end of 2 months of treatment in patients presenting with (drug-susceptible) pulmonary tuberculosis at a tertiary care hospital in Karachi. A cross-sectional study was conducted at the Department of Chest Medicine (Ward 12), Jinnah Postgraduate Medical Center (JPMC), Karachi, over 6 months. A sample of 73 consenting, newly diagnosed, smear-positive drug-susceptible pulmonary tuberculosis patients was studied. Demographic (age, gender, height, weight and duration of tuberculosis, BMI, socioeconomic, occupational, marital, educational and residential statuses) and clinical factors (chest X-ray extent and cavities, initial smear results, diabetic and smoking statuses) which may be associated with sputum non-conversion were entered in a proforma. Patients were followed up at 2 months of treatment with a sputum smear. Data analysis was done on SPSS (Statistical Package for Social Sciences-version 20.0). Rate of sputum positivity after 2 months of anti-tubercular drug treatment was 17.8%. None of the above-mentioned demographic and clinical factors was associated with persistence of sputum positivity except for the presence of CXR cavities, which made it 5.5 times more likely that the patient would remain smear-positive at 2 months (p = 0.035). The finding of chest radiograph cavities makes it highly likely that a pulmonary tuberculosis patient may remain infectious or have an unfavorable outcome despite taking treatment for 2 months. Clinicians and national policy-makers should thus bear in mind the implications this can have with regard to disease control and therefore pay particular attention to such patients in terms of stringent monitoring and directly observed treatment short-course (DOTS) provision. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s42399-021-01098-6.
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Koupaei M, Naimi A, Moafi N, Mohammadi P, Tabatabaei FS, Ghazizadeh S, Heidary M, Khoshnood S. Clinical Characteristics, Diagnosis, Treatment, and Mortality Rate of TB/COVID-19 Coinfectetd Patients: A Systematic Review. Front Med (Lausanne) 2021; 8:740593. [PMID: 34926494 PMCID: PMC8671757 DOI: 10.3389/fmed.2021.740593] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/20/2021] [Indexed: 12/23/2022] Open
Abstract
Introduction: Novel coronavirus (COVID-19) and tuberculosis (TB) are the newest and one of the oldest global threats, respectively. In the COVID-19 era, due to the health system's focus on the COVID-19 epidemic, the national TB control program received less attention, leading to a worsening of the global TB epidemic. In this study, we will review the characteristics of TB patients coinfected with COVID-19. Material and Methods: Using Scopus, PubMed/Medline, Embase, and Web of Science databases, a systematic search was performed. Case reports and case series on TB/COVID-19 coinfection published from January 1, 2019 to February 24, 2021 were collected. There were no limitations regarding publication language. Results: Eleven case series and 20 case reports were identified from 18 countries, with the majority them being from India (N = 6) and China (N = 4). Overall, 146 patients (114 men and 32 women) coinfected with TB and COVID-19 enrolled. Smoking (15.1%), diabetes (14.4%), and hypertension (8.9%) were the most frequent comorbidities among these patients. The COVID-19 patients with TB mainly suffered fever (78.8%), cough (63.7%), and respiratory distress (22.6%). Hydroxychloroquine (64.0%) and lopinavir/ritonavir (39.5%) were the most common treatments for them. The mortality rate was 13.0% and the rate of discharged patients was 87.0%. Conclusion: Global prevalence of COVID-19-related deaths is 6.6%. Our results showed that 13.0% of patients with TB/COVID-19 died. Thus, this study indicated that coinfection of TB and COVID-19 can increase the mortality. The respiratory symptoms of TB and COVID-19 are very similar, and this causes them to be misdiagnosed. In addition, TB is sometimes diagnosed later than COVID-19 and the severity of the disease worsens, especially in patients with underlying conditions. Therefore, patients with TB should be screened regularly in the COVID-19 era to prevent the spread of the TB/COVID-19 coinfection.
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Affiliation(s)
- Maryam Koupaei
- Department of Microbiology and Immunology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Adel Naimi
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Narges Moafi
- Department of Laboratory Sciences, School of Paramedical Sciences, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Paria Mohammadi
- Department of Laboratory Sciences, School of Paramedical Sciences, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Faezeh Sadat Tabatabaei
- Department of Laboratory Sciences, School of Paramedical Sciences, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Soroosh Ghazizadeh
- Department of Laboratory Sciences, School of Paramedical Sciences, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Mohsen Heidary
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran.,Department of Laboratory Sciences, School of Paramedical Sciences, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Saeed Khoshnood
- Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran
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Rakiro J, Shah J, Waweru-Siika W, Wanyoike I, Riunga F. Microbial coinfections and superinfections in critical COVID-19: a Kenyan retrospective cohort analysis. IJID REGIONS (ONLINE) 2021; 1:41-46. [PMID: 35721772 PMCID: PMC8489262 DOI: 10.1016/j.ijregi.2021.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/22/2021] [Accepted: 09/26/2021] [Indexed: 01/01/2023]
Abstract
Objectives The aim of our study was to outline the burden, risk factors, and outcomes for critical COVID-19 patients with coinfections or superinfections. Methods This was a retrospective descriptive study of adults who were admitted with critical COVID-19 for ≥ 24 hours. Data collected included demographic profiles and other baseline characteristics, laboratory and radiological investigations, medical interventions, and clinical outcomes. Outcomes of interest included the presence or absence of coinfections or superinfections, and in-hospital mortality. Differences between those with and without coinfections or superinfections were compared for statistical significance. Results In total, 321 patient records were reviewed. Baseline characteristics included a median age (IQR) of 61.4 (51.4-72.9) years, and a predominance of male (71.3%) and African/black (66.4%) patients. Death occurred in 132 (44.1%) patients, with a significant difference noted between those with added infections (58.2%) and those with none (36.6%) (p = 0.002, odds ratio (OR) = 2.41). One patient was coinfected with pulmonary tuberculosis. Approximately two-thirds of patients received broad-spectrum antimicrobial therapy. Conclusion Added infections in critically ill COVID-19 patients were relatively uncommon but, where present, were associated with higher mortality. Empiric use of broad-spectrum antimicrobials was common, and may have led to the selection of multidrug-resistant organisms. More robust local data on antimicrobial susceptibility patterns may help in appropriate antibiotic selection, in order to improve outcomes without driving up rates of drug-resistant pathogens.
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Affiliation(s)
- Joe Rakiro
- Department of Medicine, Aga Khan University Medical College of East Africa, Nairobi, Kenya
| | - Jasmit Shah
- Department of Medicine, Aga Khan University Medical College of East Africa, Nairobi, Kenya
| | - Wangari Waweru-Siika
- Department of Anesthesia, Aga Khan University Medical College of East Africa, Nairobi, Kenya.,Intensive Care Unit, Aga Khan University Hospital, Nairobi
| | - Ivy Wanyoike
- Intensive Care Unit, Aga Khan University Hospital, Nairobi
| | - Felix Riunga
- Department of Medicine, Aga Khan University Medical College of East Africa, Nairobi, Kenya
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40
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SARS-Cov-2 and Mycobacterium tuberculosis: A Mini Review. JOURNAL OF CLINICAL AND BASIC RESEARCH 2021. [DOI: 10.52547/jcbr.5.3.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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41
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Song WM, Zhao JY, Zhang QY, Liu SQ, Zhu XH, An QQ, Xu TT, Li SJ, Liu JY, Tao NN, Liu Y, Li YF, Li HC. COVID-19 and Tuberculosis Coinfection: An Overview of Case Reports/Case Series and Meta-Analysis. Front Med (Lausanne) 2021; 8:657006. [PMID: 34504847 PMCID: PMC8421570 DOI: 10.3389/fmed.2021.657006] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 07/26/2021] [Indexed: 12/24/2022] Open
Abstract
Background: Coronavirus disease 2019 (COVID-19) and tuberculosis (TB) are two major infectious diseases posing significant public health threats, and their coinfection (aptly abbreviated COVID-TB) makes the situation worse. This study aimed to investigate the clinical features and prognosis of COVID-TB cases. Methods: The PubMed, Embase, Cochrane, CNKI, and Wanfang databases were searched for relevant studies published through December 18, 2020. An overview of COVID-TB case reports/case series was prepared that described their clinical characteristics and differences between survivors and deceased patients. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) for death or severe COVID-19 were calculated. The quality of outcomes was assessed using GRADEpro. Results: Thirty-six studies were included. Of 89 COVID-TB patients, 19 (23.46%) died, and 72 (80.90%) were male. The median age of non-survivors (53.95 ± 19.78 years) was greater than that of survivors (37.76 ± 15.54 years) (p < 0.001). Non-survivors were more likely to have hypertension (47.06 vs. 17.95%) or symptoms of dyspnea (72.73% vs. 30%) or bilateral lesions (73.68 vs. 47.14%), infiltrates (57.89 vs. 24.29%), tree in bud (10.53% vs. 0%), or a higher leucocyte count (12.9 [10.5–16.73] vs. 8.015 [4.8–8.97] × 109/L) than survivors (p < 0.05). In terms of treatment, 88.52% received anti-TB therapy, 50.82% received antibiotics, 22.95% received antiviral therapy, 26.23% received hydroxychloroquine, and 11.48% received corticosteroids. The pooled ORs of death or severe disease in the COVID-TB group and the non-TB group were 2.21 (95% CI: 1.80, 2.70) and 2.77 (95% CI: 1.33, 5.74) (P < 0.01), respectively. Conclusion: In summary, there appear to be some predictors of worse prognosis among COVID-TB cases. A moderate level of evidence suggests that COVID-TB patients are more likely to suffer severe disease or death than COVID-19 patients. Finally, routine screening for TB may be recommended among suspected or confirmed cases of COVID-19 in countries with high TB burden.
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Affiliation(s)
- Wan-Mei Song
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.,Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jing-Yu Zhao
- Department of Geriatrics, People Hospital of Dongying District, Dongying, China
| | - Qian-Yun Zhang
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.,Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Si-Qi Liu
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.,Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xue-Han Zhu
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Qi-Qi An
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.,Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Ting-Ting Xu
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Shi-Jin Li
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.,Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jin-Yue Liu
- Department of Critical Care Medicine, Shandong Provincial Third Hospital, Jinan, China
| | - Ning-Ning Tao
- Department of Respiratory and Critical Care Medicine, Beijing Hospital, Beijing, China.,Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yao Liu
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.,Department of Geriatrics, People Hospital of Dongying District, Dongying, China
| | - Yi-Fan Li
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.,Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Huai-Chen Li
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.,Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.,First College of Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
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Yu F, Zhu Y, Qin X, Xin Y, Yang D, Xu T. A multi-class COVID-19 segmentation network with pyramid attention and edge loss in CT images. IET IMAGE PROCESSING 2021; 15:2604-2613. [PMID: 34226836 PMCID: PMC8242907 DOI: 10.1049/ipr2.12249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/16/2021] [Accepted: 04/23/2021] [Indexed: 05/15/2023]
Abstract
At the end of 2019, a novel coronavirus COVID-19 broke out. Due to its high contagiousness, more than 74 million people have been infected worldwide. Automatic segmentation of the COVID-19 lesion area in CT images is an effective auxiliary medical technology which can quantitatively diagnose and judge the severity of the disease. In this paper, a multi-class COVID-19 CT image segmentation network is proposed, which includes a pyramid attention module to extract multi-scale contextual attention information, and a residual convolution module to improve the discriminative ability of the network. A wavelet edge loss function is also proposed to extract edge features of the lesion area to improve the segmentation accuracy. For the experiment, a dataset of 4369 CT slices is constructed, including three symptoms: ground glass opacities, interstitial infiltrates, and lung consolidation. The dice similarity coefficients of three symptoms of the model achieve 0.7704, 0.7900, 0.8241 respectively. The performance of the proposed network on public dataset COVID-SemiSeg is also evaluated. The results demonstrate that this model outperforms other state-of-the-art methods and can be a powerful tool to assist in the diagnosis of positive infection cases, and promote the development of intelligent technology in the medical field.
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Affiliation(s)
- Fuli Yu
- School of Information Science and EngineeringEast China University of Science and TechnologyShanghai200237People's Republic of China
| | - Yu Zhu
- School of Information Science and EngineeringEast China University of Science and TechnologyShanghai200237People's Republic of China
| | - Xiangxiang Qin
- School of Information Science and EngineeringEast China University of Science and TechnologyShanghai200237People's Republic of China
| | - Ying Xin
- Department of Endocrine and Metabolic DiseasesThe Affiliated Hospital of Qingdao UniversityQingdao266003People's Republic of China
| | - Dawei Yang
- Department of Pulmonary MedicineZhongshan HospitalFudan UniversityShanghai200032People's Republic of China
| | - Tao Xu
- Department of Pulmonary and Critical Care MedicineThe Affiliated Hospital of Qingdao UniversityQingdaoShandong266000People's Republic of China
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COVID-19 and pulmonary tuberculosis - A diagnostic dilemma. Radiol Case Rep 2021; 16:3255-3259. [PMID: 34367387 PMCID: PMC8326013 DOI: 10.1016/j.radcr.2021.07.079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 12/24/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Meanwhile, pulmonary tuberculosis(TB) is one of the most common infective lung diseases in developing nations. The concurrence of pulmonary TB and COVID-19 can lead to poor prognosis, owing to the pre-existing lung damage caused by TB. Case presentation: We describe the imaging findings in 3 cases of COVID-19 pneumonia with co-existing pulmonary TB on HRCT thorax. The concurrence of COVID-19 and pulmonary TB can be a diagnostic dilemma. Correct diagnosis and prompt management is imperative to reduce mortality and morbidity. Hence it is pertinent for imaging departments to identify and report these distinct entities when presenting in conjunction.
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Key Words
- AFB, Acid-fast bacilli
- CO-RADS, COVID-19 Reporting and Data System
- COVID -19
- COVID-19, Coronavirus disease 2019
- CRP, C-reactive protein
- CT, Computed tomography
- Case report
- Co-infection
- DNA, Deoxyribonucleic acid
- DOTS, Directly Observed Therapy, Short-Course
- GGOs, Ground glass opacities
- Ground glass opacities
- HRCT
- HRCT, High resolution computed tomography
- ICU, Intensive care unit
- RT-PCR, Reverse transcriptase-polymerase chain reaction
- SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2
- TB, Tuberculosis
- Tuberculosis
- WBC, White blood cell
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Pavlovic JM, Pesut DP, Stosic MB. Influence of the COVID-19 pandemic on the incidence of tuberculosis and influenza. Rev Inst Med Trop Sao Paulo 2021; 63:e53. [PMID: 34190955 PMCID: PMC8231979 DOI: 10.1590/s1678-9946202163053] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 06/02/2021] [Indexed: 12/30/2022] Open
Abstract
We examined whether the COVID-19 pandemic has affected the incidence of
tuberculosis (TB) and influenza in Serbia, a Southeast European country with a
low TB incidence rate and a mandatory BCG vaccination at birth. The first case
of COVID-19 was registered on March 6, 2020. Despite the need for a sudden
adaptation of the health care system, routines of mycobacterial laboratories
have never stopped. In 2020, the number of newly diagnosed TB patients was
significantly lower than expected (p = 0.04), but the number of patients with
influenza increased when compared to 2019. Although many patients with influenza
A H1N1 were observed before the beginning of the COVID-19 pandemic, the
increment of cases could also be a consequence of cases of influenza with
COVID-like symptoms detected thereafter. It may also be attributed to
misclassification of clinical cases that were negative for SARS-CoV-2 and
reported as influenza. Difficulties to seek medical attention because of the
COVID-19 pandemic and possible underreporting are considered as reasons for the
decline in the incidence rate of TB. On the other hand, individual and social
measures to prevent the spread of SARS-CoV-2 such as wearing face masks, social
distancing, lockdown, which were strictly applied to COVID-19 patients, health
care staffs and most of the population, could have hindered TB infections more
than the two viral diseases, which appear to be more contagious. The increased
motivation of the population to protect their health during the COVID-19
pandemic provided an opportunity for their effective education. This is crucial
in further combating TB as a preventable disease.
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Affiliation(s)
| | - Dragica Petar Pesut
- University of Belgrade, Faculty of Medicine, Internal Medicine Department, Belgrade, Serbia.,University Clinical Center of Serbia, Teaching Hospital of Pulmonology, Belgrade, Serbia
| | - Maja Borivoje Stosic
- Public Health Institute of Serbia "Dr Milan Jovanović Batut", Department of HIV, Hepatitis, STDs and TB, Belgrade, Serbia
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González-Domenech CM, Pérez-Hernández I, Gómez-Ayerbe C, Viciana Ramos I, Palacios-Muñoz R, Santos J. A Pandemic within Other Pandemics. When a Multiple Infection of a Host Occurs: SARS-CoV-2, HIV and Mycobacterium tuberculosis. Viruses 2021; 13:931. [PMID: 34067925 PMCID: PMC8156167 DOI: 10.3390/v13050931] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/12/2021] [Accepted: 05/16/2021] [Indexed: 02/07/2023] Open
Abstract
By the middle of 2021, we are still immersed in the coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The concurrence of this new pandemic in regions where human immunodeficiency virus (HIV) and tuberculosis (TB) infections possess the same epidemiological consideration, has arisen concerns about the prognosis, clinical management, symptomatology, and treatment of patients with triple infection. At the same time, healthcare services previously devoted to diagnosis and treatment of TB and HIV are being jeopardized by the urgent need of resources and attention for COVID-19 patients. The aim of this review was to collect any article considering the three conditions (HIV, TB, and SARS-CoV-2), included in PubMed/Medline and published in the English language since the beginning of the COVID-19 pandemic. We focused on detailed descriptions of the unusual cases describing the three co-infections. Eighty-four out of 184 publications retrieved met our inclusion criteria, but only three of them reported cases (five in total) with the three concomitant infections. The clinical evolution, management, and therapy of all of them were not different from mild/severe cases with exclusive COVID-19; the outcome was not worse either, with recovery for the five patients. Cases of patients with COVID-19 besides HIV and TB infections are scarce in literature, but studies deliberately embracing the triple infection as a priori inclusion criterion should be carried out in order to provide a complete understanding of joint influence.
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Affiliation(s)
- Carmen María González-Domenech
- Clinical Research in HIV Infection, Endovascular Infection and Bacteriemia, Biomedical Research Institute of Malaga (IBIMA), 29010 Malaga, Spain; (C.G.-A.); (I.V.R.); (R.P.-M.); (J.S.)
- Department of Microbiology, Faculty of Sciences, University of Malaga, 29071 Malaga, Spain
| | | | - Cristina Gómez-Ayerbe
- Clinical Research in HIV Infection, Endovascular Infection and Bacteriemia, Biomedical Research Institute of Malaga (IBIMA), 29010 Malaga, Spain; (C.G.-A.); (I.V.R.); (R.P.-M.); (J.S.)
- Infectious Diseases and Clinical Microbiology Unit, Virgen de la Victoria Hospital, 29010 Malaga, Spain
| | - Isabel Viciana Ramos
- Clinical Research in HIV Infection, Endovascular Infection and Bacteriemia, Biomedical Research Institute of Malaga (IBIMA), 29010 Malaga, Spain; (C.G.-A.); (I.V.R.); (R.P.-M.); (J.S.)
- Infectious Diseases and Clinical Microbiology Unit, Virgen de la Victoria Hospital, 29010 Malaga, Spain
| | - Rosario Palacios-Muñoz
- Clinical Research in HIV Infection, Endovascular Infection and Bacteriemia, Biomedical Research Institute of Malaga (IBIMA), 29010 Malaga, Spain; (C.G.-A.); (I.V.R.); (R.P.-M.); (J.S.)
- Infectious Diseases and Clinical Microbiology Unit, Virgen de la Victoria Hospital, 29010 Malaga, Spain
| | - Jesús Santos
- Clinical Research in HIV Infection, Endovascular Infection and Bacteriemia, Biomedical Research Institute of Malaga (IBIMA), 29010 Malaga, Spain; (C.G.-A.); (I.V.R.); (R.P.-M.); (J.S.)
- Infectious Diseases and Clinical Microbiology Unit, Virgen de la Victoria Hospital, 29010 Malaga, Spain
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Reshetnikov MN, Plotkin DV, Zuban ON, Bogorodskaya EM. Emergency surgical care for patients with COVID-19 and tuberculosis coinfection at multispecialty hospital. BULLETIN OF RUSSIAN STATE MEDICAL UNIVERSITY 2021. [DOI: 10.24075/brsmu.2021.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The double burden of the novel coronavirus infection and tuberculosis (TB) is a global challenge. The aspects of emergency surgical care for patients with COVID-19 and TB coinfection remain understudied. The aim of this study was to assess treatment outcomes in acute surgical patients with COVID-19 and preexisting TB coinfection. In 2020, our Center delivered surgical care to 465 patients with COVID-19 and preexisting TB; a total of 64 emergency surgeries were performed on 36 (5.6%) patients, of whom 16 had HIV. Thirteen patients (36.1%) were diagnosed with pulmonary TB; 23 patients (63.9%) had disseminated TB. Chest CT scans showed >25% lung involvement in 61.9% of the patients with COVID-19 pneumonia, 25–50% lung involvement in 30.6% of the patients, and 50–75% lung involvement in 5.6% of the patients. By performing abdominal CT, we were able to detect abdominal TB complications, including perforated tuberculous ulcers of the intestine, intestinal obstruction and tuberculous peritonitis, as well as tuberculous spondylitis complicated by psoas abscess. Of all surgical interventions, 28.2% were abdominal, 23.2% were thoracic, 15.6% were surgeries for soft tissue infection, and 32.8% were other types of surgery. Postoperative mortality was 22.2%. We conclude that COVID-19 did not contribute significantly to postoperative mortality among acute surgical patients with TB.
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Affiliation(s)
- MN Reshetnikov
- Moscow Research and Clinical Center for TB Control, Moscow, Russia
| | - DV Plotkin
- Moscow Research and Clinical Center for TB Control, Moscow, Russia
| | - ON Zuban
- Moscow Research and Clinical Center for TB Control, Moscow, Russia
| | - EM Bogorodskaya
- Moscow Research and Clinical Center for TB Control, Moscow, Russia
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Feldman C, Anderson R. The role of co-infections and secondary infections in patients with COVID-19. Pneumonia (Nathan) 2021; 13:5. [PMID: 33894790 PMCID: PMC8068564 DOI: 10.1186/s41479-021-00083-w] [Citation(s) in RCA: 155] [Impact Index Per Article: 51.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/12/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND It has been recognised for a considerable time-period, that viral respiratory infections predispose patients to bacterial infections, and that these co-infections have a worse outcome than either infection on its own. However, it is still unclear what exact roles co-infections and/or superinfections play in patients with COVID-19 infection. MAIN BODY This was an extensive review of the current literature regarding co-infections and superinfections in patients with SARS-CoV-2 infection. The definitions used were those of the Centers for Disease Control and Prevention (US), which defines coinfection as one occurring concurrently with the initial infection, while superinfections are those infections that follow on a previous infection, especially when caused by microorganisms that are resistant, or have become resistant, to the antibiotics used earlier. Some researchers have envisioned three potential scenarios of bacterial/SARS-CoV-2 co-infection; namely, secondary SARS-CoV-2 infection following bacterial infection or colonisation, combined viral/bacterial pneumonia, or secondary bacterial superinfection following SARS-CoV-2. There are a myriad of published articles ranging from letters to the editor to systematic reviews and meta-analyses describing varying ranges of co-infection and/or superinfection in patients with COVID-19. The concomitant infections described included other respiratory viruses, bacteria, including mycobacteria, fungi, as well as other, more unusual, pathogens. However, as will be seen in this review, there is often not a clear distinction made in the literature as to what the authors are referring to, whether true concomitant/co-infections or superinfections. In addition, possible mechanisms of the interactions between viral infections, including SARS-CoV-2, and other infections, particularly bacterial infections are discussed further. Lastly, the impact of these co-infections and superinfections in the severity of COVID-19 infections and their outcome is also described. CONCLUSION The current review describes varying rates of co-infections and/or superinfections in patients with COVID-19 infections, although often a clear distinction between the two is not clear in the literature. When they occur, these infections appear to be associated with both severity of COVID-19 as well as poorer outcomes.
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Affiliation(s)
- Charles Feldman
- Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand Medical School, 7 York Road, Parktown, Johannesburg, 2193, South Africa.
| | - Ronald Anderson
- Department of Immunology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Ergönül Ö, Akyol M, Tanrıöver C, Tiemeier H, Petersen E, Petrosillo N, Gönen M. National case fatality rates of the COVID-19 pandemic. Clin Microbiol Infect 2021; 27:118-124. [PMID: 32979575 PMCID: PMC7510430 DOI: 10.1016/j.cmi.2020.09.024] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 09/10/2020] [Accepted: 09/15/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVES The case fatality rate (CFR) of coronavirus disease 2019 (COVID-19) varies significantly between countries. We aimed to describe the associations between health indicators and the national CFRs of COVID-19. METHODS We identified for each country health indicators potentially associated with the national CFRs of COVID-19. We extracted data for 18 variables from international administrative data sources for 34 member countries of the Organization for Economic Cooperation and Development (OECD). We excluded the collinear variables and examined the 16 variables in multivariable analysis. A dynamic web-based model was developed to analyse and display the associations for the CFRs of COVID-19. We followed the Guideline for Accurate and Transparent Health Estimates Reporting (GATHER). RESULTS In multivariable analysis, the variables significantly associated with the increased CFRs were percentage of obesity in ages >18 years (β = 3.26; 95%CI = 1.20, 5.33; p 0.003), tuberculosis incidence (β = 3.15; 95%CI = 1.09, 5.22; p 0.004), duration (days) since first death due to COVID-19 (β = 2.89; 95%CI = 0.83, 4.96; p 0.008), and median age (β = 2.83; 95%CI = 0.76, 4.89; p 0.009). The COVID-19 test rate (β = -3.54; 95%CI = -5.60, -1.47; p 0.002), hospital bed density (β = -2.47; 95%CI = -4.54, -0.41; p 0.021), and rural population ratio (β = -2.19; 95%CI = -4.25, -0.13; p 0.039) decreased the CFR. CONCLUSIONS The pandemic hits population-dense cities. Available hospital beds should be increased. Test capacity should be increased to enable more effective diagnostic tests. Older patients and patients with obesity and their caregivers should be warned about a potentially increased risk.
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Affiliation(s)
- Önder Ergönül
- Koç University, School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey; Koç University Research Centre for Infectious Diseases, Istanbul, Turkey; ESCMID Emerging Infections Task Force, ESCMID, Basel, Switzerland.
| | - Merve Akyol
- Koç University, School of Medicine, Istanbul, Turkey
| | - Cem Tanrıöver
- Koç University, School of Medicine, Istanbul, Turkey
| | - Henning Tiemeier
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Eskild Petersen
- ESCMID Emerging Infections Task Force, ESCMID, Basel, Switzerland; Institute for Clinical Medicine, Faculty of Health Sciences, University of Aarhus, Denmark
| | - Nicola Petrosillo
- ESCMID Emerging Infections Task Force, ESCMID, Basel, Switzerland; National Institute for Infectious Diseases 'L. Spallanzani', IRCCS, Rome, Italy
| | - Mehmet Gönen
- Koç University Research Centre for Infectious Diseases, Istanbul, Turkey; Koç University, School of Medicine, Istanbul, Turkey; Koç University, College of Engineering, Department of Industrial Engineering, Istanbul, Turkey
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Loh J, Tham SM, Tambyah PA, Yan G, Lee CK, Chai LYA. Range of Varicella Zoster Co-Infections with COVID-19, Singapore. Infect Chemother 2021; 53:391-394. [PMID: 34216133 PMCID: PMC8258286 DOI: 10.3947/ic.2020.0154] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 04/20/2021] [Indexed: 12/18/2022] Open
Abstract
There have been recent descriptions of the novel coronavirus disease 2019 (COVID-19) presenting as 'varicella-like exanthem'. We report three cases of patients with Varicella-Zoster Virus (VZV) and COVID-19 co-infections, presenting in three varied ways. These cases highlight the need for heightened alertness to how such co-infections can present, to pick up overlapping 'dual pathologies' during this current pandemic given that infection control measures including airborne precautions are crucial for both COVID-19 and VZV.
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Affiliation(s)
- Jerold Loh
- Division of Infectious Diseases, University Medicine Cluster, National University Health System, Singapore.
| | - Sai Meng Tham
- Division of Infectious Diseases, University Medicine Cluster, National University Health System, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Paul Anantharajah Tambyah
- Division of Infectious Diseases, University Medicine Cluster, National University Health System, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Gabriel Yan
- Division of Infectious Diseases, University Medicine Cluster, National University Health System, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Division of Microbiology, Department of Laboratory Medicine, National University Health System, Singapore
| | - Chun Kiat Lee
- Molecular Diagnosis Centre, Department of Laboratory Medicine, National University Health System, Singapore
| | - Louis Yi Ann Chai
- Division of Infectious Diseases, University Medicine Cluster, National University Health System, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Aguilar-León P, Cotrina-Castañeda J, Zavala-Flores E. SARS-CoV-2 infection and pulmonary tuberculosis: an analysis of the situation in Peru. CAD SAUDE PUBLICA 2020; 36:e00094520. [PMID: 33331591 DOI: 10.1590/0102-311x00094520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 08/24/2020] [Indexed: 11/22/2022] Open
Affiliation(s)
- Pool Aguilar-León
- Hospital Nacional Cayetano Heredia, Universidad Peruana Cayetano Heredia, Lima, Perú
| | | | - Ernesto Zavala-Flores
- Hospital Nacional Cayetano Heredia, Universidad Peruana Cayetano Heredia, Lima, Perú
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